Optic atrophy

Optic atrophy, or degeneration of the optic nerve, can develop spontaneously (primary) or can follow inflammation or edema of the nerve head (secondary). Some forms of this condition may subside without treatment, but degeneration of the optic nerve is irreversible.

Causes

Optic atrophy usually results from central nervous system disorders (such as chiasmal tumors, syphilis, ischemic optic neuropathy, drugs, retinal vascular disease, or degenerative disease) or from end-stage glaucoma. Other causes include retinitis pigmentosa; chronic papilledema and papillitis; glaucoma; trauma; central retinal artery or vein occlusion that interrupts the blood supply to the optic nerve, causing degeneration of ganglion cells; ingestion of toxins, such as methanol and quinine; and deficiencies of vitamin B ₁₂, amino acids, and zinc.

There are several rare forms of hereditary optic atrophy that can affect children and young adults.

Signs and symptoms

Optic atrophy causes abrupt or gradual painless loss of visual field or visual acuity, with subtle changes in color vision.

Diagnosis

CONFIRMING DIAGNOSIS Visual acuity testing reveals poor vision. An afferent pupillary defect is noted when pupils are examined. Fundus examination through a dilated pupil with an ophthalmoscope shows pallor of the nerve head from loss of microvascular circulation in the disk and deposit of fibrous or glial tissue. Visual field testing reveals a scotoma and, possibly, major visual field impairment.

Treatment

Optic atrophy is irreversible, so treatment aims to correct the underlying cause and prevent further vision loss. Steroids may be given to decrease inflammation and swelling, if the cause is found to be ischemic neuropathy. If a space-occupying lesion is the cause, neurosurgery may be required. In multiple sclerosis, optic neuritis often subsides spontaneously but may recur and improve repeatedly.

Special considerations

❑ Provide symptomatic care during diagnostic procedures and treatment. Assist the patient who’s visually compromised to perform daily activities.

❑ Explain procedures, to minimize anxiety. Offer emotional support to help the patient deal with loss of vision.

Book Source Details

• Book Title: Professional Guide to Diseases (Eighth Edition)
• Author(s): Springhouse
• Year of Publication: 2005
• Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

Other Book Chapters Related to Muscle atrophy

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Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2008 Williams & Wilkins.

More About Causes of Muscle atrophy

• Back to symptom: Muscle atrophy: Introduction (review 311 causes)
• Next Book Extract About Muscle atrophy: Muscle flaccidity [Muscle hypotonicity] (Professional Guide to Signs & Symptoms (Fifth Edition))
• All Book Extracts: All Online Book Extracts for Muscle atrophy

More About This Book: Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X

 » Next page: Muscle flaccidity [Muscle hypotonicity] (Professional Guide to Signs & Symptoms (Fifth Edition))

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