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Diagnosis requires exclusion of other neurological, ophthalmological, and systemic conditions. [3] Any cause of optic neuropathy should be ruled out, including demyelinating ( MOG antibody disease , multiple sclerosis , and neuromyelitis optica ) and systemic disease (diabetic, toxic, nutritional, and infectious causes). [ 3 ]
The optic disc is where the axons from the retinal ganglion cells collect into the optic nerve. The optic nerve is the bundle of axons that carry the visual signals from the eye to the brain. This optic nerve must penetrate through the wall of the eye, and the hole to accommodate this is usually 20-30% larger than the nerve diameter.
The diagnosis of toxic or nutritional optic neuropathy is usually established by a detailed medical history and careful eye examination. If the medical history clearly points to a cause, neuroimaging to rule out a compressive or infiltrative lesion is optional. However, if the medical history is atypical or does not clearly point to a cause ...
In children, optic disc drusen are usually buried and undetectable by fundoscopy except for a mild or moderate elevation of the optic disc. With age, the overlying axons become atrophied and the drusen become exposed and more visible. They may become apparent with an ophthalmoscope and some visual field loss at the end of adolescence. [7]
Major symptoms are sudden loss of vision (partial or complete), sudden blurred or "foggy" vision, and; pain on movement of the affected eye. [4] [5] [2]Many patients with optic neuritis may lose some of their color vision in the affected eye (especially red), with colors appearing subtly washed out compared to the other eye.
Laser treatment of drusen has been studied. While it is possible to eliminate drusen with this treatment strategy, it has been shown that this fails to reduce the risk of developing the choroidal neovascularisation which causes the blindness associated with age-related macular degeneration. [15]
The diagnosis of PION is often difficult since the optic nerves initially appear normal. The injury occurs posterior to that portion of the nerve visible during ophthalmoscopic examination. There may be an abnormal relative pupillary response (APD) if the injury is confined to one optic nerve, but often it is bilateral and the symmetry of ...
Arteritic anterior ischemic optic neuropathy (arteritic AION, A-AION or AAION) is vision loss that occurs in giant cell arteritis (also known as temporal arteritis).Temporal arteritis is an inflammatory disease of medium-sized blood vessels that happens especially with advancing age.
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