Diagnosis
- History. History is critical in the diagnosis of optic atrophy since the physician needs to know how the eye arrived at this juncture.
- Physical examination. ...
- Signs. ...
- Symptoms. ...
- Clinical diagnosis. ...
- Diagnostic procedures. ...
- Laboratory test. ...
- Differential diagnosis. ...
What is optic atrophy and what causes it?
Optic atrophy is a condition in which the optic nerve begins to deteriorate. The optic nerve is the nerve at the back of your eye that connects your eye to your brain, allowing you to see. There are a couple of different optic atrophy types.
What are the tests for optic atrophy?
The following work up should be considered for patients presenting with unexplained optic atrophy: Check for afferent pupil. Visual fields 30-2,color vision. MRI of brain and orbit with contrast. CT with contrast (check bony disease, sinuses) Blood pressure and check of cardiovascular health (carotids, etc.), Glucose.
What is ophthalmic atrophy (OA)?
Optic Atrophy (OA) refers to a neuro-ophthalmic condition and is not considered a disease. Atrophy, here, refers to the wasting away or progressive decline of the nerve fiber of the optic nerve.. What is affected is the primary retinal ganglion cells (RGC) and the axons forming the optic nerve.
Is there a cure for optic atrophy?
There is no real cure or treatment for optic atrophy. Therefore, it's important to have regular eye exams (especially if you have a family history of eye diseases), and to see your ophthalmologist immediately if you have any changes in your vision.
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How is optic nerve atrophy diagnosed?
How is optic nerve atrophy diagnosed? Paleness (pallor) of the typically pinkish optic nerve is observed by the eye M.D. during dilated examination with an ophthalmoscope. Testing usually includes assessment of visual acuity, pupils, ocular alignment, head position and nystagmus.
What is the most common cause of optic atrophy?
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.
What tests show optic nerve damage?
Magnetic resonance imaging (MRI). During an MRI to check for optic neuritis, you might receive an injection of a contrast solution to make the optic nerve and other parts of your brain more visible on the images. An MRI is important to determine whether there are damaged areas (lesions) in your brain.
Can an eye exam detect optic nerve damage?
During an eye exam, the ophthalmologist checks the optic nerve, the nerve that sends messages from the eye to brain. Multiple sclerosis (MS) causes inflammation in the optic nerve, which leads to a condition called optic neuritis. One of the earliest signs of MS is blurred vision.
Can optic atrophy be cured?
Unfortunately, medical science has not yet developed an effective treatment for Optic Atrophy, because once nerve fibers are lost, they cannot heal and do not grow back. However early diagnosis and treatment of the underlying cause of optic atrophy can help prevent damage from getting worse.
What is mild optic atrophy?
Optic atrophy type 1 is a condition that often causes slowly worsening vision, usually beginning in childhood. People with optic atrophy type 1 typically experience a narrowing of their field of vision (tunnel vision). Affected individuals gradually lose their sight as their field of vision becomes smaller.
Can an optometrist see your optic nerve?
The eye is a beautiful organ, and it is the only place in the human body where a doctor can see a part of the central nervous system, the optic nerve. The observation of that nerve is a crucial part of a comprehensive eye examination.
Does optic nerve damage show on MRI?
MRI can show optic nerve compression by swollen extraocular muscles, and it can demonstrate inflammation of extraocular muscles and orbital fat tissue with high-intensity signal on STIR images. The optic nerve in dysthyroid optic neuropathy is almost normal on conventional MRI.
Can an eye exam detect neurological problems?
“Patients can present with a fairly sudden onset of vision loss in one or both eyes, and there's often pain with movement of the eye.” Another thing that could point to a neurological problem during an exam: eye-movement abnormality.
Can optometrist see optic nerve inflammation?
Your eye doctor can diagnose optic neuritis during a routine eye exam through a series of vision tests and looking at the structures inside your eye. Blood tests and MRIs may be ordered to check for other conditions related to optic neuritis.
Can eye doctor see optic nerve without dilation?
The optic nerve can be seen through an undilated pupil, but for optimum viewing a dilated pupil is required. This is important for the diagnosis of glaucoma, as well as other diseases of the optic nerve. Learn about what to expect during a glaucoma eye exam.
What can cause optic nerve atrophy?
Optic atrophy can occur in cases where the optic nerve did not develop properly. It may also result from inflammation of the optic nerve or from glaucoma when the pressure inside the eye remains too high. In unusual cases, poisons, vitamin deficiencies, or tumors may be responsible.
Is optic nerve atrophy serious?
Optic atrophy is not a disease, but rather a sign of a potentially more serious condition. Optic atrophy results from damage to the optic nerve from many different kinds of pathologies. The condition can cause problems with vision, including blindness.
How do you reverse optical atrophy?
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.
What is the single root cause of vision loss?
Although cataracts, macular degeneration, diabetic retinopathy, and glaucoma are the most common causes of vision loss, there are other vision loss culprits. Those include: Dry eye. Eye injury.
What is Optic Atrophy?
Optic Atrophy is a condition of the nervous system that affects the vision by the shrinking of the optic nerve. Early detection of Optic Atrophy is...
What is the ICD-10 code for Optic Atrophy?
The 2021 ICD-10-CM Diagnosis Code for optic atrophy is H47. 2.
Is Optic Atrophy genetic?
Yes, it can be. Hereditary Optic Atrophy includes Leber Hereditary Optic Atrophy and Dominant Optic Atrophy. They are considered to be mitochondria...
Can you see with Optic Atrophy?
Yes, however, the extent of vision functionality varies from person to person. Some individuals do experience complete loss of vision.
Does Optic Atrophy get worse over time?
Yes, it is a progressive loss of vision but damage can be limited with proper medical intervention.
How rare is Optic Atrophy?
It is considered a rare condition, affecting approximately 1 in 35,000 people. The prevalence of blindness due to Optic Atrophy is 0.8%.
Can Optic Atrophy cause blindness?
Yes, Optic Atrophy can result in blindness.
What are the symptoms of Optic Atrophy?
The main symptoms of optic atrophy include: Abnormal peripheral side vision Decreased brightness in one eye compared with the other eye Blurred vis...
Can Optic Atrophy be cured?
No, there is currently no available cure, but research is in motion such as neuroregeneration, cited the University of Cambridge.
What is Optic Atrophy?
Optic Atrophy (OA) refers to a neuro-ophthalmic condition and is not considered a disease. Atrophy, here, refers to the wasting away or progressive decline of the nerve fiber of the optic nerve.. What is affected is the primary retinal ganglion cells (RGC) and the axons forming the optic nerve. The RGC and axons process visual information which begins as light entering the eye, which then gets transmitted to the brain.
Why is the optic nerve pink?
Lack of blood flow and compression of the optic nerve can be a primary cause. The normal, healthy color of the optic disc is pink, due to the rich vascularization.
What is the condition of the nervous system that affects the vision by the shrinking of the optic nerve?
Optic Atrophy is a condition of the nervous system that affects the vision by the shrinking of the optic nerve.
How can assistive devices help with optic atrophy?
Assistive devices can help individuals with Optic Atrophy to improve their vision. For example, eSight technology stimulates synaptic activity from remaining photoreceptor function, thereby providing more information to the brain to process, and thus improving the visual field for affected individuals.
How to diagnose optic atrophy?
Diagnosis of Optic Atrophy can be made by using an ophthalmoscope to observe the optic disc. This is done by an ophthalmologist. Pallor of the disc is indicative of limited blood flow, suggesting OA and leading to nerve damage. Further ophthalmologic tests can be done including checking peripheral vision and the ability to distinguish colors from one another.
What is the cause of Leber's optic atrophy?
Leber Hereditary Optic Atrophy occurs due to mitochondrial DNA abnormality which impedes cellular respiration. The primary and typically earliest sign of Hereditary Optic Atrophy is vision loss. It commonly occurs in males (about 80 – 90% of those affected are male), but only females can pass on the abnormality to the next generation.
Why is my vision blurry?
Any damage to the nerve fibers can cause blurry vision because damage to the optic nerve can prevent the brain from getting the information it needs to create a clear image .
What is the goal of management of optic nerve damage?
Management. The management goal is to intervene before optic atrophy is noted or to save remaining function. This will depend on the underlying cause for the optic nerve damage. For instance, intraocular pressure control in glaucoma, control of inflammation in sarcoid, etc.
Why are the margins of the optic nerve pale?
This is the end stage of a process resulting in optic nerve damage. Because the optic nerve fiber layer is thinned or absent the disc margins appear sharp and the disc is pale, probably reflecting absence of small vessels in the disc head.
What is optic nerve damage?
Optic atrophy is somewhat of a misnomer as atrophy implies disuse, and thus optic nerve damage is better termed optic neuropathy.
How many axons are in the optic nerve?
The optic nerve is a bundle of 1.2 million axons of retinal ganglion cells that carries visual information from the retina to the brain. The optic nerve is myelinated by oligodendrocytes that do not regenerate after damage. In optic nerve atrophy there is loss of axons and shrinkage of myelin leading to gliosis and widening of the optic cup.
What is the term for the death of the ganglion cell axons that comprise the optic nerve?
Optic atrophy refers to the death of the retinal ganglion cell axons that comprise the optic nerve with the resulting picture of a pale optic nerve on fundoscopy. Optic atrophy is an end stage that arises from myriad causes of optic nerve damage anywhere along the path from the retina to the lateral geniculate.
What is the primary prevention of optic atrophy?
Primary prevention. Optic atrophy is the end stage of a process causing damage to the optic nerve. Medical practice is currently unable to return function (regrow axons) to an atrophic optic nerve, and at best is able to stabilize whatever function remains. Primary prevention (removal of the process causing the damage) is ...
How does optic nerve damage affect vision?
Since the optic nerve is the conduit for information from the retina to the brain, a damaged optic nerve will result in vision loss. Subtle damage might not affect acuity but may lead to a loss of contrast or color vision. Severe damage may lead from legal blindness to no light perception. Damage to a part of the optic nerve results in loss of vision in the corresponding visual field. Occasionally if the process causing damage is removed before apoptosis occurs (as for instance removal of a pituitary tumor compressing the chiasm or reducing inflammation in sarcoid) some improvement in visual function may be noted. A complete diagnosis is based on optic nerve appearance, tests of visual function (visual field, contrast, color, acuity), identifying the causative factor of the damage, and ruling out other causes for vision loss (such as retinal causes).
What is the name of the inflammation of the optic nerve?
Optic neuritis. Optic neuritis is an inflammation of the optic nerve. It may be associated with eye pain worsened by eye movement. It is more common in young to middle-aged women. Some patients with optic neuritis may develop multiple sclerosis later on in life.
What causes optic nerve damage?
Optic atrophy can be defined as damage to the optic nerve resulting in a degeneration or destruction of the optic nerve. Optic atrophy may also be referred to as optic nerve head pallor because of the pale appearance of the optic nerve head as seen at the back of the eye. Possible causes of optic atrophy include: optic neuritis, Leber's hereditary optic atrophy, toxic or nutritional optic neuropathy, glaucoma, vascular disorders, trauma, and other systemic disorders.
How does optic atrophy work?
Using a hand-held instrument called an ophthalmoscope, the doctor can see the optic nerve head (optic disc) which is the part of the optic nerve that enters at the back of the eyeball. In optic atrophy, the disc is pale and has fewer blood vessels than normal.
What are the symptoms of optic atrophy?
This change in visual function can be a decrease in sharpness and clarity of vision (visual acuity) or decreases in side (peripheral) vision. Color vision and contrast sensitivity can also be affected.
How to diagnose inherited diseases?
Diagnosis involves recognizing the characteristic changes in the optic disc with an ophthalmoscope , and measuring visual acuity , usually with an eye chart. Visual field testing can test peripheral vision. Color vision and contrast sensitivity can also be tested. Family history is important in the diagnosis of inherited conditions. Exposure to poisons, drugs, and even medications should be determined. Suspect ed poisoning can be confirmed through blood and urine analysis, as can vitamin deficiency.
What is the cause of glaucoma?
Glaucoma. Glaucoma may be caused by an increase of pressure inside the eye. This increased pressure may eventually affect the optic nerve if left untreated.
What is the mitochondria?
Mitochondia —A structure in the cell responsible for producing energy. A defect in the DNA in the mitochondria is involved in Leber's optic neuropathy.
