Optic Neuropathy as a Rare Ocular Complication of Acute Pancreatitis: A Case Report

TL;DR

A rare case of optic neuropathy occurring in a patient with acute pancreatitis is reported, highlighting the importance of early diagnosis to prevent permanent vision loss.

Contribution

This case report adds to the limited literature on optic neuropathy as a rare complication of acute pancreatitis.

Findings

Optic neuropathy was diagnosed in a patient with acute pancreatitis and showed significant improvement with steroid treatment.

The case emphasizes the need to consider optic neuropathy and Purtscher-like retinopathy in patients with acute pancreatitis presenting with ocular symptoms.

Abstract

Acute pancreatitis is a pancreatic inflammatory disorder that often leads to multi-organ dysfunction associated with systemic inflammatory response. Optic neuropathy is an extremely rare ocular manifestation that can occur especially in alcoholic pancreatitis most likely due to ischemic complications and is a vision-threatening condition that has to be recognized early as it can cause permanent vision loss. In this case report, a 51-year-old lady, an occasional consumer of alcohol, post-cholecystectomy status, presented with severe abdominal pain of four days' duration associated with multiple episodes of vomiting. She was diagnosed with moderate to severe acute pancreatitis and needed ionotropic support initially. She had improvement in gastrointestinal symptoms. However, she had left peri-orbital pain and lacrimation with blurring of vision on Day 11 of illness. Subsequently, an ophthalmic evaluation revealed optic disc oedema and a mild decrease in visual acuity but normal visual field and colour vision. Therefore, left optic neuropathy was diagnosed and a high-dose oral steroid was started on a tapering dose. Follow-ups after four and 12 weeks showed significant improvement in optic disc oedema and other symptoms. Therefore, though optic neuropathy is rarely reported in acute pancreatitis, it has to be considered in clinical practice along with Purtscher-like retinopathy, which presents with ocular symptoms in acute pancreatitis.

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