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Optic Nerve Atrophy (ONA)

Last updated Dec. 13, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Optic Nerve Atrophy (ONA) is a permanent visual impairment that occurs, when the optic nerve is damaged or injured.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Atrophic Optic Nerve
  • Optic Disc Pallor Excessive
  • Optic Neuropathy

What is Optic Nerve Atrophy? (Definition/Background Information)

  • Optic Nerve Atrophy (ONA) is a permanent visual impairment that occurs, when the optic nerve is damaged or injured. The optic nerve is responsible for carrying information from the eye to the brain, enabling sight
  • Optic Nerve Atrophy can be the result of complications due to many diseases/conditions. It can affect a single eye, or both eyes
  • The prognosis depends on the cause of the disorder. In some cases, ONA can lead to total blindness

Who gets Optic Nerve Atrophy? (Age and Sex Distribution)

  • There is no gender or age preference observed in those affected by Optic Nerve Atrophy
  • However, African Americans (0.3%) in the United States, have a higher incidence of the condition than Caucasians (0.05%)

What are the Risk Factors for Optic Nerve Atrophy? (Predisposing Factors)

Following are the risk factors for Optic Nerve Atrophy:

  • Direct or indirect, physical injury to the eye
  • Genetics (a family history of the condition)
  • History of stroke
  • Development of optic neuropathies (damaged optic nerve) 

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Optic Nerve Atrophy? (Etiology)

There are many cause factors for Optic Nerve Atrophy, and these may be unrelated to each other. These include:

  • Ischemic optic neuropathy: Condition, where there is a deprived blood flow to the optic nerve
  • Optic neuritis: Inflammation of the optic nerve
  • Compressive optic neuropathy: Optic disc swelling (optic disc is the point of origin of the optic nerve) and progressive visual loss from lesions in the optic canal (part of a skull bone though which optic nerve gets connected from the eye to the brain)
  • Infiltrative optic neuropathy: Tumors, inflammation, and infections infiltrate the optic nerve
  • Traumatic optic neuropathy: Optic nerve damage due to direct or indirect physical injury
  • Mitochondrial optic neuropathies: Caused due to diminished efficiency of mitochondria in nerve cells
  • Nutritional optic neuropathies: Occurs due malnourishment in the eye
  • Toxic optic neuropathies: Methanol (home-brewed alcohol) causes Optic Nerve Atrophy in both eyes
  • Hereditary optic neuropathies: Inherited neuropathies that result in visual loss in both eyes
  • Glaucoma: Nerve damage due to an increased fluid pressure in the eye
  • Stroke: Rapid loss of brain function due to a lack of blood flow to the brain
  • Multiple Sclerosis: Loss of myelin (insulator in nerve cells) and scarring, resulting in physical and mental problems
  • Cranial arteritis: Inflammation of the blood vessels pertaining to the head
  • Brain tumor: Abnormal growth of brain cells that compresses the optic nerve

What are the Signs and Symptoms of Optic Nerve Atrophy?

Optic Nerve Atrophy causes the follows signs and symptoms, in one or both eyes:

  • Loss of vision; dim and reduced field of vision
  • Visual acuity loss (loss of acute vision); not able to see clearly
  • Faded colors; colors appear dull, with decreased depth of colors
  • Diminished pupil sensitivity to light, which makes it difficult for an individual to adapt to bright lights
  • Loss of side (peripheral) vision or abnormal side vision. There is no loss of direct vision (when looking straight)

How is Optic Nerve Atrophy Diagnosed?

An Optic Nerve Atrophy is diagnosed as follows:

  • Complete physical examination and evaluation of medical history
  • Color vision test: A test that checks one’s ability to differentiate different colors
  • Test of pupil light reflex: A test that assess pupil dilation response to the intensity of light falling on the eye
  • Tonometry (glaucoma test): A test to measure the pressure inside an individual’s eye
  • Visual acuity (20/20) test: In order to determine the smallest letters a person can read from a card, held 20 feet away 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Optic Nerve Atrophy?

  • The complications of Optic Nerve Atrophy are determined by the cause(s) of optic nerve degeneration
  • In some instances, a complete and irreversible loss of vision can occur

How is Optic Nerve Atrophy Treated?

There is no proven treatment method (that has held promise) for Optic Nerve Atrophy disorder, because once optic nerve cells die, they will not grow back or form again. However, some possible future treatment measures include:

  • Intravenous steroids
  • Stem cell treatment

How can Optic Nerve Atrophy be Prevented?

  • Many cases of Optic Nerve Atrophy may not be preventable, since it is caused by a variety of diseases/conditions
  • Nevertheless, routine (or yearly) eye exams can help with an early diagnose of any damage (to the eye or optic nerve), and slow vision loss or vision retardation

What is the Prognosis of Optic Nerve Atrophy? (Outcomes/Resolutions)

Optic Nerve Atrophy is not curable; however, additional loss of vision can be prevented, if the cause of the degeneration is discovered early. 

Additional and Relevant Useful Information for Optic Nerve Atrophy:

Optic Nerve Atrophy is not a disorder that can be corrected by wearing suitable glasses.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 28, 2013
Last updated: Dec. 13, 2018