Optic atrophy

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 28, 2016
StartDiseasesOptic atrophy

Optic atrophy is a condition that can cause blindness. There are many causes, and it is important to detect them early for the best outcomes.


Definition & Facts

Optic atrophy refers to a group of conditions that have a wide variety of causes that range from disease to trauma. Nonetheless, it refers to when the optic nerve has degenerated or deteriorated, and it has limited capacity to send signals about the images from the retina of the eye to the brain. The vision of those individuals with optic atrophy is either partially or seriously diminished. Optic atrophy is often indicative of a serious underlying condition.

Symptoms & Complaints

The most important signs and symptoms of optic atrophy all include changes to the eyes. One of the most significant warning signs for optic atrophy is a change in vision.

For example, a person may notice that the sharpness and acuity of their vision has changed, and they do not see as clearly as they did previously. They may also notice they cannot see peripherally, and/or they may notice a difference in color vision contrast. In addition, an individual may experience blurred vision or a decrease in the brightness in one eye when compared to the other.

When examined by a doctor, one is likely to find that there is poor constriction of the pupil when exposed to bright light and that there are changes to the optic disc in the eye. It is important to note that the symptoms that occur with optic atrophy are not exclusive to this condition. In other words, simply having one or more of the symptoms of optic atrophy does not mean that a person has the disorder.

Still, the symptoms are serious and can be indicative of other urgent problems. It is important for anyone experiencing any of the signs to get checked by an eye specialist, usually an ophthalmologist, because other serious eye diseases could also be present.


There are a number of possible causes of damage to the optic nerve. Optic neuritis is an inflammation of the myelin that surrounds the optic nerve. The nerve coating can become swollen and damaged from any type of infection, an autoimmune disease, diabetes mellitus, digestive problems, allergies, or poor circulation.

There are also hereditary conditions, such as Leber’s hereditary optic neuropathy, which can be the source of optic atrophy. A person with Leber’s hereditary optic neuropathy usually develops the condition in their late teens or early 20s and usually has a family history of the disorder.

Toxic or nutritional neuropathy can be caused by poisonous substances such as alcohol or tobacco, or the lack of the proper vitamins being absorbed from food in the diet. A disease left untreated, such as syphilis can be a factor in the eye condition. Elevated eye pressure that is seen in glaucoma can also be a source of optic atrophy.

Finally, any tumors in the brain, near the optic nerve, can mechanically interfere with the function of the optic nerve. Nonetheless, even with so many potential causes, the exact cause of optic atrophy is still unknown or idiopathic in many cases.

Diagnosis & Tests

The diagnosis of optic atrophy begins with a complete eye examination by an ophthalmologist. The doctor will test for visual acuity, color contrast, and peripheral vision. Tests to determine how the pupil constricts with light and tests designed to detect glaucoma may also be done at this time.

The doctor will likely also use an ophthalmoscope to look at the optic disc at the back of the eye. The optic disc is the place where the optic nerve enters the eye, and it is likely to be pale when optic atrophy is present. This is due to changes in circulation that occur with atrophy. This paleness is usually the telltale sign that optic atrophy is present.

However, the doctor will likely try to ascertain the exact cause of the atrophy through various means. He or she may perform a complete physical exam to test cardiovascular function, blood sugar levels, and more.

Blood testing can identify certain infections in addition to vitamin deficiencies, particularly vitamin B12 deficiency and folate deficiency as well as the presence of toxins such as heavy metals. If a tumor or multiple sclerosis is suspected, a magnetic resonance imaging (MRI) scan may be ordered to analyze the possibility.

Treatment & Therapy

Treatment for optic atrophy is highly dependent on the cause of the condition. It is imperative that the underlying causes be diagnosed early to be able to save the person’s vision because once vision is lost due to nerve damage, it generally cannot be recovered. If only one eye is affected, it is very important to protect the unaffected eye as much as possible.

While it is often not possible to recover vision that has been lost, it may be possible to slow down or stop further loss. A person who suffers from high levels of toxins or a vitamin deficiency may be able to correct these levels to decrease the likelihood of further vision loss.

When detected early, glaucoma can be successfully treated and the eye pressure decreased to prevent further vision loss. Finally, it may be possible to treat brain tumors that are found early. This can decrease the pressure on the optic nerve so that the rate of vision loss may be decreased.

Prevention & Prophylaxis

Many of the causes of optic atrophy are not preventable. Still, it is important to visit an eye doctor annually as it may be possible to catch some symptoms early, such as with glaucoma.

Additionally, it is important to protect the eyes and face from injury and trauma as much as possible. Since car accidents are the number one cause of many facial injuries, wearing seat belts is essential.

Eating a healthy diet and limiting or eliminating cigarette smoking and alcohol consumption are also important approaches for reducing the risk of optic atrophy. Taking care of overall health including blood pressure, blood sugar, and other chronic issues can also help reduce the risk of eye diseases.