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Optic nerve atrophy

Definition

Optic nerve atrophy is damage to the optic nerve. The optic nerve carries images of what we see from the eye to the brain.

Alternative Names

Optic atrophy; Optic neuropathy

Causes

There are many unrelated causes of optic atrophy. The most common cause is poor blood flow, called ischemic optic neuropathy, which most often affects elderly people. The optic nerve can also be damaged by shock, various toxic substances, radiation, and trauma.

Various eye diseases, most commonly glaucoma, can also cause a form of optic nerve atrophy. In addition, the condition can be caused by diseases of the brain and central nervous system, such as:

There are also several rare forms of hereditary optic nerve atrophy that affect children and young adults.

Symptoms

Optic nerve atrophy causes vision to dim and reduces the field of vision. The ability to see fine detail will also be lost. Colors will seem faded. The pupil reaction to light will diminish and may eventually be lost.

Exams and Tests

Optic nerve atrophy can be seen during a complete examination of the eyes. The examination will include tests of:

  • Color loss
  • Pupil light reflex
  • Tonometry
  • Visual acuity

You may need a complete physical examination and specific tests.

Treatment

Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated, if possible, to prevent further loss.

Rarely, conditions that lead to optic atrophy may be treatable.

Outlook (Prognosis)

Vision lost to optic nerve atrophy cannot be recovered. If the cause can be found and controlled, further vision loss and blindness may be prevented. It is very important to protect the other eye.

Possible Complications

Complications are related to the disease that causes the atrophy.

When to Contact a Medical Professional

Patients with optic nerve atrophy will be closely monitored by an ophthalmologist who has experience in neuro-ophthalmology. Tell your doctor right away about any change in vision.

Prevention

Many causes of optic nerve atrophy cannot be prevented.

Ways to protect yourself include:

  • Older adults should have their health care provider carefully manage their blood pressure.
  • Prevent injuries to the face by using standard safety precautions. Most injuries to the face are related to motor vehicle accidents and can be prevented by using seat belts.
  • Schedule a routine annual eye exam to check for glaucoma.

Methanol, which is found in home-brewed alcohol, can cause optic nerve atrophy in both eyes. Never drink home-brewed alcohol and forms of alcohol that are not intended for drinking.

References

Balcer LJ, Brasad S. Abnormalities of the optic nerve and retina. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann;2008:chap 15.

Arnold AC. Ischemic optic neuropathies. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 9.7.

Wax M, Clark A, Civan MM. Mechanisms of glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier;2008:chap 10.3.

Review Date: 7/28/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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