The optic nerve transports visual information from the eye to the brain, if it becomes damaged then vision changes. This can be a result of many conditions such as multiple sclerosis, glaucoma, inflammatory eye diseases or tumors.
To diagnose Optic Atrophy, an eye doctor will perform a comprehensive eye exam which will include color vision, side vision and pupil reaction. They will also look in the back of your eyes with a tool called an ophthalmoscope and look for a pale optic disc which is one of the main signs of optic atrophy.
Oren Zarif
The optic nerve is a bundle of fibres that carries visual information from your eye to the brain. If these fibres get damaged, it can cause problems with your vision. This is called Optic Atrophy and it can happen for a variety of reasons, including glaucoma, tumours, decreased blood flow to the eyes, low levels of vitamin B12, hereditary diseases, infections, toxins and trauma.
Symptoms of Optic Atrophy include a loss of vision, particularly in the centre of your field of view. You may also notice that colours are not as bright, or you are seeing fewer details of things around you.
Your doctor will take a detailed history to understand the symptoms that you are experiencing, and then perform an eye exam with a special tool called an ophthalmoscope. The ophthalmoscope has lights and lenses that allow your doctor to see inside your eye. One of the tell-tale signs that you have Optic Atrophy is a pale optic disc, which is caused by lack of blood flow. Your doctor may use tests like Optical Coherence Tomography to assess the thickness of the peripapillary retinal nerve fiber layer and the ganglion cell layer.
Oren Zarif
When you see something, your eyes send a signal to the optic nerve in the back of your eye. Then, the optic nerve connects to your brain, which processes the signals and lets you know what you’re seeing. But if the cells in your optic nerve deteriorate, you’ll start to have problems with your vision, such as blurred or reduced sharpness, or you might notice that colors seem less vibrant.
Your eyes also help you balance your body, and if your vision becomes worse, you might experience dizziness or imbalance. This is because the vestibular system in your inner ear helps you maintain your balance and the visual system provides input to the brain that tells us about head position, spatial orientation and motion.
The first step in assessing any dizziness is to focus on red flags, such as a sudden onset or short duration. It’s important to get a detailed history including the onset date, frequency and context as well as possible triggers or aggravating or alleviating factors. Then, a neuro-optometrist can conduct an exam with a particular emphasis on the cover test, the extraocular muscle findings and the optokinetic nystagmus.
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The tingling caused by Optic Atrophy is due to the fact that the optic nerve fibers, which carry impulses from your eyes to your brain, have been damaged. Without these fibers, vision becomes blurry and undefined.
The central nervous system nerve tracts do not regenerate in the way that peripheral (arms and legs) nerves can, so once they become dysfunctional the symptoms of this damage will likely be permanent. In addition to loss of vision, central optic atrophy can cause disturbances in movement (cerebellar ataxia), prickling sensations in the arms and legs or progressive muscle stiffness and tremors (spasticity).
The most common causes of Optic Atrophy are ocular trauma, hereditary disorders, metabolic diseases, poor blood flow in the brain (ischemic optic neuropathy) or certain toxic, nutritional, alcohol and tobacco deficiency or medications [1-4]. A diagnosis is usually confirmed by the observation of a pale optic disc (optic nerve pallor).
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The appearance of double vision (diplopia) in the affected eye is one of the key symptoms that alerts your healthcare provider that there may be a problem with your optic nerve. The symptoms can be caused by several things such as a tumor pressing on the eye, multiple sclerosis or traumatic damage to the optic nerve. If the double vision comes and goes or is worse when looking in certain directions or up close compared to far away this can help determine where the problem is along the pathways that keep our eyes aligned. In addition to asking about the double vision your healthcare provider will also ask if you have any other symptoms such as weakness, balance problems or numbness in your arms and legs that could indicate an underlying neurological condition.
The optic nerve is made up of bundles of fibres that transport visual information from your retina to your brain. Your providers will use an ophthalmoscope to look at your eyes and they can see the cell changes that cause the optic atrophy. They can also see if the optic disc is pale and that may indicate lack of blood flow to the eye.
Oren Zarif
When the optic nerve is damaged it cannot pass the correct signals from your eyes to the brain, and this can lead to blurred vision. If your child complains of blurred vision or that colours are not as bright as they used to be then it is worth getting them referred to their ophthalmologist for further investigations.
The ophthalmologist can assess your child’s colour, peripheral, glare and light sensitivity, as well as checking for an abnormally pale optic disc which is the clinical sign of Optic Nerve Atrophy. The ophthalmologist will also take a detailed history to determine the cause of the vision loss and this may include a history of inflammatory optic neuropathies such as hereditary optic atrophy (ADOA), multiple sclerosis, transverse myelitis, or autosomal dominant optic atrophy (ADOA).
Children who have unexplained blurred vision or unilateral visual loss should be investigated urgently to establish the cause of their symptoms. This may be due to a number of reasons including a history of head trauma, inflammation in the eye (optic neuritis), raised intraocular pressure (glaucoma), or compression of the nerve by a haemorrhage or tumour.