NAION typically occurs in older individuals with vascular risk factors. While NAION has been reported in the setting of post-partum complications of hemorrhage or severe pre-eclampsia, cases of  NAION in uncomplicated pregnancy are rare. 

Our patient experienced a four-day history of painless peripheral vision loss in her right eye. Her medical history was unremarkable, and her pregnancy was uncomplicated. Examination showed 20/20 visual acuity, normal color vision, and extraocular movements bilaterally. However, the right eye exhibited a relative afferent pupillary defect, an inferior altitudinal field defect, and 2-3+ optic nerve edema.

Comprehensive investigations were conducted to evaluate for demyelinating/ inflammatory and infectious conditions. A non-contrast MRI of the brain and orbits showed questionable T2 prolongation in the right optic nerve without other abnormalities. A five-day course of IV Solumedrol 1000 mg was administered for the vision loss, but symptoms remained constant. A lumbar puncture performed for intermittent headaches and otherwise static symptoms revealed normal opening pressure (21 cm of H2O).

At labor induction five days post-admission, the patient had two systolic blood pressure readings of 150, indicating pre-eclampsia. She underwent an uncomplicated cesarean section. Follow-up MR imaging of the brain, and orbits with contrast showed no abnormal enhancement, and she was discharged with stable symptoms.