Signs

• Moderate to severely reduced visual acuity in affected eye (typically 6/12 to 6/60)
• A sector or all of the optic nerve may be swollen with splinter or flame shaped haemorrhages [see image]
• Relative afferent pupillary defect
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  Relative afferent pupillary defect (RAPD)

  A relative afferent pupillary defect (RAPD) is seen on examination by shining light in one eye, then the other.

  If the left eye has an RAPD it will show little constriction of the pupil when a light is shone into that eye, but when the light is shone into the right eye, the left constricts.

  When swinging back to the left eye it paradoxically dilates, as it is not as responsive to stimulation (as the optic nerve is damaged).

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• Visual field defect corresponding to the area of optic disc swelling. The most common is an inferior altitudinal defect