Optic Atrophy

What is Optic Atrophy?


Optic atrophy is not a disease, but a condition.

Light carries visual information about the world around us. Light travels through the clear outer coating of your eye, known as the cornea, and your pupil to enter your eye. Once inside your eye, the light strikes a light-sensitive layer of tissue that lines the back of your eye. This tissue, known as the retina, absorbs the light and converts the visual information into electrical pulses. These electrical signals travel through a bundle of nerve fibers, known collectively as the optic nerve, to the brain. Your brain then translates the electrical pulses into the images we “see.”

A blurry image of leaves; depiction of the vision of someone with optic atrophy.

Optic Nerve

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. The phrase “optic atrophy” means the optic nerve has lost some or all of its nerve fibers.

Retina

The retina is highly vascular, which means it contains a lot of blood vessels that deliver oxygen and nutrients to the retina, the optic nerve, and other tissues of the eye.

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Prevalence of Optic Atrophy


The prevalence of blindness caused by optic atrophy is 0.8%, according to a New England Journal of Medicine study cited in a Medscape report, which noted that another report in Archives of Ophthalmology found prevalence of visual impairment was 0.04%, and blindness was 0.12%. It’s a rare condition by any standard.

The prevalence of optic atrophy differs by race, with occurrence being 0.3% in African Americans, compared to 0.5% in Caucasians. This condition affects both genders equally and it can occur at any age.

Signs and Symptoms


Blurry photo of city landscape at night.

The most common signs and symptoms are dimming of vision and a reduction in the patient’s field of view. Patients typically lose their ability to see in fine details as well, noted Medline. This might be the first time a person notices something is happening to their vision.

What’s more, colors will gradually start to appear more faded and less vivid. As the condition worsens, pupils become less reactive to light. In some cases, the patient may lose all ability to react to light. In all cases, at the first suspicion of a problem with vision is the time to book an appointment with an eye doctor for investigation and diagnosis.

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Causes of Optic Atrophy


As optic atrophy is a condition that has a number of causes, diagnosis may begin at the primary care provider or in the office of your eye doctor. Generally, an underlying condition is getting in the way of the optic nerve conducting signals to the brain. According to the Cleveland Clinic, the most common causes include:

  • Glaucoma
  • Optic nerve formed improperly before birth
  • Vision loss occurs in one eye first, and then the other, indicating patient has an inherited condition called Leber’s hereditary optic neuropathy
  • Multiple sclerosis causes optic neuritis, which is a swelling or inflammation of the optic nerve caused by MS
  • A growing tumor is pressing on the patient’s optic nerve

Such various potential causes of optic atrophy underscore the importance of visiting a primary care provider on a regular basis as well as seeing an eye doctor at least once a year for routine surveillance of eye health. After all, symptoms that present themselves in the eyes can sometimes be the first signs of another undiagnosed health condition, detected by the eye doctor before they are discovered by a family doctor.

Diagnosis


Diagnosis occurs when an ophthalmologist uses an ophthalmoscope to gaze at the optic disk. The optic disk is located in the back of the eye, where the optic nerve connects. If the doctor sees that the optic disc is pale, it’s a sign that blood flow has changed in the area. Poor blood flow leads to nerve damage, with nerve fibers deteriorating.

Rainbow of colours.

During the examination, the ophthalmologist may conduct other diagnostic tests as well, including checking peripheral vision and the ability to distinguish colors from one another. In cases where the doctor surmises the problem could be tied to multiple sclerosis or a tumor, the patient could be a candidate for testing with a magnetic resonance imaging or MRI machine.

Early detection of optic atrophy is essential for limiting the future progression of this condition. Damage from optic atrophy is not reversible, so patients with symptoms should address it as soon as possible with their doctor.

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Options and Support


Eye exam.

Currently there is no treatment to reverse the damage caused by optic atrophy. However, it’s prudent to consult with a doctor to learn about any underlying disease that could cause the condition to progress further. This includes regularly monitoring blood pressure and taking steps to keep it under control, with supervision from primary health care providers. Be sure to schedule eye exams once per year, to be screened for possible glaucoma.

To gain greater peace of mind about optic atrophy, it’s worth considering joining a local support group. Comparing notes about experiences can provide insight into how others have handled their vision loss.

A good place to start in finding local resources for supporting a patient with optic atrophy is the Genetic and Rare Diseases Information Center’s page on Optic Atrophy, run through the United States National Institutes of Health.

Available Technology for Optic Atrophy


eSight 4, low vision assistive technology

Many eSight users live with optic atrophy. eSight functions by stimulating synaptic activity from the remaining photoreceptor function of its users’ eyes and provides the brain with increased visual information to naturally compensate for gaps in the user’s field of view. 

Many successful eSight users live with optic atrophy, such as Cosmo Moore, who experienced 20/40 vision for the first time in his life while using eSight, as opposed to his usual 20/400. He now works as an eSight coach helping others to use, what he calls, this “spectacular piece of technology.”

Technical Specifications

For those who are legally blind, eSight is clinically validated to enhance vision to up to 7 lines on a doctor’s eye chart. It has a leading edge camera, liquid lens, and high definition display powered by smart algorithms. The high-speed, high-resolution 21.5 MP camera captures and then projects real-time footage onto two OLED screens in front of the eyes. 

FAQs

What is optic atrophy?

Optic atrophy is a term that describes damage that prevents the optic nerve from transmitting signals about what we see to the brain.

Can optic atrophy cause vision loss?

Yes. Optic atrophy can cause vision problems that range from visual changes to severe visual loss.

What are the symptoms of optic atrophy?

The symptoms of optic atrophy include:

    • Blurred vision
    • Abnormal color vision
    • Abnormal peripheral side vision
    • Decreased brightness in one eye compared with the other eye

Having these symptoms does not necessarily mean you have optic atrophy, but you may benefit from a trip to your eye doctor if you are having one or more of these symptoms.

What causes optic atrophy?

A number of diseases and disorders can damage the optic nerve bundles to cause optic atrophy. In some cases, the optic nerve does not develop properly. In other cases, inflammation of the optic nerve or the high pressure inside the eye from glaucoma may cause optic atrophy. Rarely, poisons, vitamin deficiencies, or tumors can damage the optic nerve fibers. In most cases, optic atrophy has no known cause.

How do eye doctors diagnose optic atrophy?

Eye doctors diagnose optic atrophy through a comprehensive eye exam that assesses your visual acuity (which is the sharpness of your vision), color vision, peripheral side vision, and how well your pupils react to light.

What is the treatment for optic atrophy?

Unfortunately, medical science has not yet developed an effective treatment for optic atrophy, because once the nerve fibers are lost, they cannot heal and they can never grow back. The good news is that early diagnosis and treatment of the underlying cause of optic atrophy can help prevent damage from getting worse.

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