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CAPS Task Force recommendations (2020) and real-world experience support this stepwise approach

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Patients face these permanent life-altering consequences from NAION-related blindness: Sudden blindness in affected eye: Most experience dense altitudinal visual field loss affecting top or bottom half, with some suffering complete blindness Inability to drive or work: Vision loss severe enough to disqualify from driving and render many occupations impossible Constant risk to fellow eye: Living with approximately 15% risk over five years that the second eye will suffer identical fate No restorative treatment options: Unlike cataracts, NAION leaves patients with zero medical solutions for recovery Permanent disability from NAION has made these injuries central to litigation