People who experience rapidly progressing loss of vision should seek immediate medical help, because this may be a sign of elevated pressure in the brain that could lead to permanent blindness in the future.
In the journal Neurology, Dr Madhav Thambisetty of Emory University in Atlanta and colleagues reported on 16 patients with the condition of fulminant idiopathic intracranial hypertension.
IIH usually worsens fairly slowly, and rapid progression is usually due to a secondary cause such as a blood clot in the brain or meningitis. But in the 16 patients described, no secondary causes were identified.
“Although fulminant IIH is rare, it affects young, otherwise healthy women, who often become legally blind over the course of a few days,” Dr Thambisetty and his team said.
All the patients were women, with an average age of 24. All were obese and all had experienced headaches before seeking treatment, while nine had nausea and vomiting. Nine had ringing in their ears, eight had temporary blurry vision and five had double vision.
Eleven underwent a shunting procedure to relieve pressure on the brain, and optical nerve sheath fenestration – in which “windows” are cut into the tissue surrounding the nerve – was performed in five. Fourteen of the patients had some visual improvement after treatment, but eight remained legally blind.