Optic nerve atrophy

  • Definition
    • Optic nerve atrophy is damage to the optic nerve. The optic nerve carries images of what the eye sees to the brain.

  • Alternative Names
    • Optic atrophy; Optic neuropathy

  • Causes
    • There are many causes of optic atrophy. The most common is poor blood flow. This is called ischemic optic neuropathy. The problem most often affects older adults. The optic nerve can also be damaged by shock, toxins, radiation, and trauma.

      Eye diseases, such as glaucoma, can also cause a form of optic nerve atrophy. The condition can also be caused by diseases of the brain and central nervous system. These may include:

      There are also 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. Over time, the pupil will be less able to react to light, and eventually, its ability to react to light may be lost.

  • Exams and Tests
    • The health care provider will do a complete eye exam to look for the condition. The exam will include tests of:

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

      You may also need a complete physical exam and other tests.

  • Treatment
    • Damage from optic nerve atrophy cannot be reversed. The underlying disease must be found and treated. Otherwise, vision loss will continue.

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

  • Outlook (Prognosis)
    • Vision lost to optic nerve atrophy cannot be recovered. It is very important to protect the other eye.

  • When to Contact a Medical Professional
    • People with this condition need to be checked regularly by an eye doctor with experience in nerve-related conditions. Tell your doctor right away about any change in vision.

  • Prevention
    • Many causes of optic nerve atrophy cannot be prevented.

      Prevention steps include:

      • Older adults should have their health care provider carefully manage their blood pressure.
      • Use standard safety precautions to prevent injuries to the face. Most facial injuries are the result of car accidents. Wearing seat belts may help prevent these injuries.
      • Schedule a routine annual eye exam to check for glaucoma.
      • Never drink home-brewed alcohol and forms of alcohol that are not intended for drinking. Methanol, which is found in home-brewed alcohol, can cause optic nerve atrophy in both eyes.
  • References
    • Balcer LJ, Prasad S. Abnormalities of the optic nerve and retina. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 15.

      Purvin V, Glaser JS. Topical Diagnosis: Prechiasmal Visual Pathways. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 2, chap 5.

      Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 431.