Optic disc hypoplasia
 

The left disc is smaller compared with the right (in some cases there is peripapillary atrophy, if there is pigmentary  changes in the inner and outer rings the disc gives a double ring sign). The blood vessels may enter the optic disc  at an angle (giving an appearance of tilted disc). Examination: there may be associated nystagmus in the involved eye there may be strabismus or afferent pupillary defect is the involvement is unilateral

Questions:

1. What are the causes of optic nerve hypoplasia?

Answer
idiopathic
inherited
de Morsier's syndrome (septo-optic dysplasia) which is the absence of the septum pellucidum with pituitary hypoplasia
maternal drug ingestions (such as alcohol in fetal alcohol syndrome, LSD and phenytoin)
intrauterine infection

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