“Death is not extinguishing the light; it is only putting out the lamp because the dawn has come.” -Rabindranath Tagore
However, if it is the nerve cells in your eyes that are dying, then it is very likely that the light in your eyes will soon be extinguished. This is what happens in the condition, optic atrophy…
Optic atrophy is the death of nerve fibres that make up the optic nerve which transmits visual information from your eye to your brain. It is the end stage that can arise due to a variety of causes of damage to your optic nerve. It is also called Optic neuropathy.
• Poor blood supply: this is the most common cause and it commonly affects elderly people. This type is called ischemic atrophy.
• Various eye diseases like glaucoma and papilledema (swelling of the optic nerve head). This is called pressure atrophy.
• Diseases of the brain or central nervous system like brain tumours, aneurysms (abnormal bulging of your blood vessels), stroke, multiple sclerosis (an auto-immune disease), cranial arteritis (inflammation of the blood vessels supplying your brain and eyes).
• Inflammatory conditions like Sarcoidosis, Systemic Lupus Erythematosus, Behcet’ disease etc.
• Infections like herpes, TB, Bartonella etc.
• Toxic substances, Tobacco, Methyl alcohol, thyroid ophthalmopathy: This type is called as metabolic atrophy.
• Hereditary: e.g. Leber’s optic neuropathy (an inherited condition where there is degeneration of the cells of your retina), Kjer-type optic atrophy (a rare genetic disorder in
which decreased vision is seen from childhood)
Blurry vision: The loss of vision may be central or peripheral depending on the disease causing optic atrophy.
Decreased field of vision
Reduced ability to see fine details
Colours may seem faded or contrast may be affected
Pain in your eyes (when it is associated with glaucoma)
Complete eye examination including:
• Colour vision testing
• Visual Acuity testing
• Tonometry (measurement of pressure inside your eyes)
• Pupil light reflex
• Optical Coherence Tomography
• Electrophysiology (ERG or mERG)
• B-Scan Ultrasound to detect papilledema
• Ultrasonography to detect tumours in the eye socket
• Additional tests may be needed like blood tests or CT/MR imaging of your brain and eye to identify the cause.
Damage caused by optic atrophy is usually irreversible. Treatment is aimed at halting the progress of the damage to your optic nerve and preserving your present vision.
The underlying disease has to be found and treated accordingly.
Optic neuritis leading to optic atrophy can be treated using intravenous steroids (steroid medications given via your blood vessels).
The main way to prevent optic atrophy is to diagnose and treat the diseases that cause optic atrophy so that they do not progress to the end stage.
• Protect your face and eyes from injuries by using regular safety precautions for e.g. use seat belts while driving to prevent vehicle accidents.
• Monitor your blood pressure levels regularly especially in the case of older adults.
• Undergo a routine eye examination for glaucoma every year.