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Optic Nerve Atrophy

What is the optic nerve?

The optic nerve contains over one million nerves that connect the retina (back of the eye) with the occipital lobe (vision part of the brain) like a cable wire.

What is optic nerve atrophy?

Optic nerve atrophy (ONA) is mild to severe damage to the optic nerve that can adversely affect central vision, peripheral vision and color vision. ONA that occurs as a child may result in nystagmus (rhythmic involuntary eye movements) [See figures 1 and 2].

What causes optic nerve atrophy?

ONA causes include: tumor, trauma, decreased blood supply (ischemia) or oxygen supply (hypoxia), heredity, hydrocephalus, toxins, infection, and rare degenerative disorders. Onset can be from birth through adulthood.

Fig. 1 Normal optic nerve.

How is optic nerve atrophy diagnosed?

Paleness (pallor) of the typically pinkish optic nerve is observed by the eye M.D. during ophthalmoscopic examination. Testing usually includes assessment of visual acuity, pupils, peripheral vision, and color vision and less commonly with MRI scan, electroretinography (ERG), visual evoked potential (VEP) and optical coherence tomography (OCT). Age and cooperation can limit testing.

What treatment is available for optic nerve atrophy?

There is no treatment to reverse atrophy of the optic nerve; however, limiting further optic nerve damage (if possible) is the goal. For example, reduction of increased fluid pressure around the brain and spinal cord (hydrocephalus) may prevent further optic nerve damage. Spectacles may be prescribed to correct refractive error and protect the eyes. Magnifiers or tinted lenses may also improve visual function.

Fig. 2 Atrophic optic nerve.

What else can be done for a child with optic nerve atrophy?

A child with ONA may have significantly reduced vision and thus need special assistance for school. A personalized learning plan via cooperation between educational specialists, schoolteachers, and low vision specialists (sometimes with optical devices) facilitates a maximal learning experience.