LAUSR

late staining. A diagnosis of LE acute NAION was made. He was given a course of systemic steroids, and his vision improved in the LE. Although systemic steroids are controversial in management of NAION (2), we feel it is helpful in young patients (3). Since patient was neither diabetic nor hypertensive and a basic blood work-up including homocysteine levels was normal, a hypercoagulable work-up was performed and he was found to have homozygous mutation in factor II prothrombin gene G20210A. He was referred to a hematologist who recommended lifelong anticoagulation therapy. At 6-month follow-up, he had no recurrences in the LE with a visual acuity of 20/ 125 and his RE continued to be normal and unaffected. Hence, we agree with Dr. Francis that in a setting of a young patient ,50 years of age with no systemic risk factors such as diabetes and hypertension, a hypercoagulable work-up is not only useful to protect the other eye from NAION, but given a longer life expectancy in these patients, it could also protect the patient from overall thromboembolic events anywhere else in the body, some of which could be life threatening.