Anterior ischemic optic neuropathy following the use of a nasal decongestant

PURPOSE: To report a case of sequential anterior ischemic optic neuropathy temporally related to the sequential use of a decongestant nasal spray. METHODS: A 43-year-old woman was evaluated for sequential bilateral vision loss following the use of oxymetazoline nasal spray. RESULTS: Thorough investigation of possible etiologies causing the bilatera l anterior ischemic optic neuropathy was negative. Our patient had several predisposing risk factors for ischemic optic neuropathy, including diabetes mellitus, hypertension, and crowded optic nerve heads. Before each acute o ptic neuropathy, the patient used two to three puffs of oxymetazoline nasal spray. CONCLUSION: Decongestants have been associated with ischemic and hemorrhagi c vascular events. Vasoconstriction secondary to oxymetazoline use may prec ipitate anterior ischemic optic neuropathy. (C) 1999 by Elsevier Science In c. All rights reserved.