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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Optic nerve atrophy

Optic atrophy; Optic neuropathy

Last reviewed: September 3, 2012.

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

Causes, incidence, and risk factors

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.

Signs and tests

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

  • Color vision
  • Pupil light reflex
  • 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.

Expectations (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.

Complications

Complications are related to the disease that causes the atrophy.

Calling your health care provider

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

  1. 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.
  2. Yanoff M, Cameron D. Diseases of the visual system. In:Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.

Review Date: 9/3/2012.

Reviewed by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Acupuncture as a treatment modality for patients with glaucoma
    Glaucoma is a condition that damages the optic nerve and affects primarily the side vision. It is a major cause of blindness worldwide. Although many treatments are available, including eye drops, laser treatment, and surgical procedures, some patients may seek complementary or alternative medicine approaches such as acupuncture to supplement their regular treatment. This review aimed to evaluate available evidence in the findings of randomized controlled trials to assess whether acupuncture is useful and safe in treating patients with glaucoma. We included in the review one completed and one ongoing trial, and we recorded seven trials (all published in Chinese) awaiting assessment for eligibility. The completed trial was conducted in Taiwan among 33 patients. This trial compared auricular acupressure-a nonstandard acupuncture technique-versus a sham procedure (which is a fake procedure designed to resemble the real one) for glaucoma. The trial measured intraocular pressure and visual acuity during an eight‐week follow‐up period. The quality of this trial was not high. According to the findings of this trial, auricular acupressure lowers intraocular pressure by around 4 mm Hg for the right eye and around 5 mm Hg for the left eye at four weeks, but not significantly effective at any other time points or for any other visual outcomes. The safety of acupuncture was not examined in this trial. To date, the ongoing trial "Acupuncture for Glaucoma" has not recruited any participants. On the basis of currently available evidence, the benefit and harm of acupuncture as a therapeutic modality for glaucoma cannot be established. Inclusion of the seven Chinese trials that are awaiting assessment for eligibility in the future may change our conclusions.
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