Neuro-ophthalmologic vascular emergencies in the elderly.

The significance, management and prognosis of several disorders affecting either vision or ocular motility are discussed. Transient and persistent visual loss are common problems in the elderly. Anterior ischemic optic neuropathy is extensively reviewed because of the importance of recognizing forms due to giant cell arteritis, which require urgent treatment with steroids to prevent further visual loss. The various pathologic conditions that can affect the ocular motor nerves in the cavernous sinus are mentioned. The problem of differentiating benign ischemic lesions causing a third nerve palsy from ominous compressive palsies due to aneurysms is addressed, with emphasis on the clues provided by the pupil.