A 53-year-old black female presented with the chief complaint of a sudden onset of poor vision in the right eye for two days duration. Her systemic history was positive for sickle cell anemia.

Diagnostic Data
Her best corrected acuity was 20/200 O.D. and 20/30 O.S. at distance and near. External examination found evidence of a significant confrontational visual field defect and a grade 3 relative afferent pupillary defect O.D.

The patients posterior segment O.D. is pictured above. Her visual field O.D. is at right.
Goldmann intraocular pressures measured at 14mm Hg, both eyes.

The pertinent posterior segment findings and visual field are demonstrated in the images.

Your Diagnosis
How would you approach this case? Does this patient require any additional tests? What is your diagnosis?

How would you manage this patient? Whats the likely prognosis?

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Vol. No: 141:08Issue: 8/15/04