Optic nerve atrophy is a disease that damages the eye, impairs vision and reduces the ability to distinguish colors. The disease can occur in anyone and cause permanent blindness if not treated promptly and properly.

1. What is optic nerve atrophy?

Optic nerve atrophy is a condition in which the optic nerve is destroyed due to any cause, thereby limiting the ability to transmit information from the eye to the brain. Symptoms of optic nerve atrophy often include: decreased vision, decreased ability to perceive colors and eye pain when moving.

The consequences of the disease affect both distance vision, near vision and the ability to perceive colors of the eye, and can eventually lead to blindness if optic nerve atrophy is not treated. The elderly often have optic nerve atrophy due to reduced blood flow to the optic nerve.

Optic nerve atrophy accounts for about 0.8% of the causes of blindness. This is not a disease but a consequence of many different diseases.

There are no statistics on the incidence of optic nerve atrophy by gender, it can occur at any age, including congenital optic nerve atrophy.

2. Causes of optic nerve atrophy

The optic nerve is responsible for transmitting crude images from the retina to the visual processing center in the cerebral cortex in the form of electrical impulses, helping us see objects clearly. There are many groups of causes of optic nerve atrophy.

Image of optic nerve atrophy.

• Optic nerve ischemia

This is the most common cause. The optic nerve ischemia when the vascular pressure is less than the intraocular pressure. Optic nerve atrophy due to ischemia is often seen in the context of central venous artery occlusion, carotid artery occlusion, and cranial arteritis. The location of the damaged blood vessel determines the specific treatment method.

Optic nerve atrophy due to ischemia can also occur after radiation therapy to the head and neck area from 3 months to 8 years, on average about 1.5 years due to damage to the vascular stromal tissue, which can be combined with damage to the optic disc.

Some systemic diseases such as hypertension, diabetes, and atherosclerosis also cause vascular damage and reduce the blood supply to the optic nerve, which is common in the elderly.

• Optic neuritis

Optic neuritis causes edema and damage to the myelin sheath surrounding the nerve fibers. This is the most common cause of optic nerve atrophy and sudden visual loss in young people between the ages of 20 and 50, especially in women. This condition, when combined with demyelination of the white matter of the brain, is suggestive of multiple sclerosis.

• Compressive optic nerve atrophy

Tumors, infections, and inflammation can lead to lesions within the orbit. These lesions can compress the optic nerve, causing optic disc edema and progressive visual loss. This condition can also be seen in glaucoma.

• Optic nerve infiltration

The optic nerve can be infiltrated by a variety of causes such as tumors, inflammation, and infection. Tumors can be primary in situ such as optic neuritis, capillary or cavernous hemangiomas, or secondary tumors such as metastatic carcinoma, nasopharyngeal cancer, lymphoma, and leukemia. The most common inflammatory disorder infiltrating the optic nerve is sarcoidosis.

Anemia causes optic nerve atrophy.

• Optic nerve injury

Direct trauma to the head or eye socket disrupts the anatomical structure and physiological function of the optic nerve, such as gunshots or stab wounds. Indirect trauma, such as car accidents, can also cause optic nerve damage. The most common site of injury is the segment of the optic nerve within the skull.

• Hereditary optic nerve atrophy

Hereditary optic nerve atrophy is divided into congenital optic nerve atrophy, which is inherited as a recessive or dominant gene, Behr’s optic nerve atrophy, which is inherited as a recessive gene, and Leber’s optic nerve atrophy, which is caused by a point mutation in the mitochondria.

• Other causes

Optic nerve atrophy can be caused by nutritional deficiencies (protein, vitamin B, vitamin B12, folic acid); or due to toxic substances such as tobacco, methyl alcohol, ethylene glycol, cyanide, lead and carbon mono oxide…

3. Symptoms of optic nerve atrophy

Symptoms of optic nerve atrophy are quite easy to recognize, including:

• Reduced vision for several hours to several days, sometimes occurring suddenly overnight. The patient’s vision becomes blurred quickly. Vision can be reduced more or less depending on the severity of the patient’s disease. When the optic nerve atrophies completely, the patient will be blind.
• Color disturbances: Sharpness and the ability to distinguish colors are significantly reduced in the damaged eye, easily recognizable when compared to the healthy eye. The most common is red-green color disturbances. The progression of the disease depends mainly on the cause of the disease.
• Pain in the eye socket: Dull pain in the eye or deep in the eye socket, pain especially increases when moving the eye.

4. Is optic nerve atrophy contagious?

Optic nerve atrophy is not contagious.

5. How to prevent optic nerve atrophy

Optic nerve atrophy is the final stage of the optic nerve destruction process, causing irreversible damage. Therefore, the most basic prevention is to detect and treat underlying diseases to preserve the remaining function of the unaffected optic nerve.

Optic nerve atrophy causes marked loss of vision and blurred vision.

6. Treatment of optic nerve atrophy

The treatment of optic nerve atrophy is mainly to treat the cause of the disease. There is no way to restore the damaged nerve. Treatment before the progression to optic nerve atrophy helps preserve eye function. For example, glaucoma patients need to have good control of intraocular pressure, using steroids to control the inflammatory process in optic neuritis.

Along with the treatment of the cause, vitamins, anti-atherosclerosis drugs, drugs that increase metabolism in nerve cells, increase blood flow, antioxidants, anti-hypertensive drugs, and blood sugar regulators can be prescribed.

In some cases, thread implantation can be used to improve vision and enhance vision for people with optic nerve atrophy. However, the rate of recovery from the disease is quite low because any damage to the optic nerve tends to be permanent because nerve cells cannot regenerate or repair.