Acute Visual Loss - Case 5

A 64 year old, healthy female comes to the emergency room complaining of a sudden, painless loss of vision in her right eye (OD).

Physical examination revealed acuity of 20/20 OS, and 20/200 OD, visual field loss superiorly, normal extraocular movements, pupils of equal size but with a relative afferent pupillary defect (RAPD) OD.  Funduscopy was normal OS, but showed a pale, swollen disc OD (below).

Case 5

What should be the next step in this patient's management?

Fluoroscein angiography
Erythrocyte sedimentation rate
Complete blood count
Immediate ophthalmology consult
All of the above
None of the above