Optic atrophy
The optic disc is pale. Note: if the patient is pseudophakic in one eye and has cataract in the other, the disc in the pseudophakic eye may appear paler in the absence of optic atrophy.

The following features may help in the diagnosis. 

  • Excavated appearance with the blood vessels dipping the edge (glaucoma)
  • Indistinct edge with glial tissue (chronic papilloedema)
  • Well-defined edge without excavation (opitc nerve

  • disease)
    Look for:
    • in young patient, mention you like to examine the eyes for internuclear ophthalmoplegia and cerebellar sign for multiple sclerosis
    • in old patient, look for evidence of vascular diseases such as prominent temporal artery (or old scar indicating temporal artery biopsy) and carotid bruit 

    • (or endarterectomy scar)


    1. What is Leber's optic optic neuropathy?

    2. Which types of optic nerve problems are characterized by centrocecal scotoma?

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