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What are Optic Nerve Drusen?

Donn Saylor
Donn Saylor

Optic nerve drusen are small deposits of protein matter that build up in the optic disc. Also known as optic disc drusen or optic nerve head drusen, these protein pockets calcify and can cause potential vision problems. The condition affects a very small number of people — about one percent of the population — and symptoms are exceedingly rare, even in individuals who have a major buildup of drusen. In a few highly unusual instances, drusen has led to vision loss.

Experts are not entirely certain how and why drusen develop. One commonly held theory is that mucopolysaccharides — a type of carbohydrate structure — and mucoproteins accumulate as a side-effect of cell metabolism. Many patients with optic nerve drusen have inherited the condition from a family member, though a genetic basis is not a prerequisite for the development of drusen. They develop in both eyes more often than in just one eye.

Protein pockets that build up in the optic disc can cause vision issues.
Protein pockets that build up in the optic disc can cause vision issues.

In the majority of cases, optic nerve drusen present no noticeable problems and are detected only during a regular eye examination. Many eye doctors find that a patient with drusen buildup possess a slight aberration in side vision to such a minor extent that the patient does not notice it. The severity of any side vision problems can be deduced by a more thorough examination, in which a patient's side vision is tested with special "visual field" machines. If an eye doctor is unsure whether optic nerve drusen is present, he or she may order a CT scan, an optic ultrasound, or a fundoscopy to gather a more definitive diagnosis.

Calcified optic nerve drusen can cause vision problems.
Calcified optic nerve drusen can cause vision problems.

By its very nature, damage to the optic nerve is progressive. While most patients with optic nerve drusen do not go blind, other conditions may develop over time. Some of the most frequently reported vision issues are enhanced blind spots, general weakness in the main line of vision, and other abnormalities in the visual field.

There is no definitive treatment for optic nerve drusen nor are there any preventative measures that can be undertaken to ensure they don't develop. An individual with drusen is commonly examined regularly by a doctor to gauge the extent of the buildup or any additional growth that may have occurred. Some doctors may prescribe eye drops that alleviate intraocular strain and allay pressure on the fibers of the optic disc. Certain cases of optic nerve drusen may necessitate laser therapy, though this type of treatment is rare.

Discussion Comments

stoneMason

@ZipLine-- You're right, but keep in mind that optic nerve drusen increases the risk of high eye pressure. And high eye pressure is one of the factors that contribute to glaucoma and vision loss.

So diagnosing high eye pressure early and keeping it under control with eye drops can be considered part of optic nerve drusen treatment. You can't just ignore the condition.

Sometimes, optic nerve drusen can be a result of some other underlying condition like a tumor. So make sure that the cause of deposits is identified.

ZipLine

@fBoyle-- I've just been diagnosed with a mild case of optic nerve drusen. My doctor is not worried about it at all and has not mentioned treatment. He only asked me to get check-ups twice a year to keep track of any changes. My eyesight is not affected much for now, I just have floaters sometimes.

As far as I understand, this condition doesn't usually cause blindness. In most people, it will only cause mild vision problems like floaters or difficulty reading. It's not as serious as symptoms of glaucoma.

fBoyle

How can there be no treatment for this condition? So if someone is diagnosed with optic nerve drusen, are they supposed to just sit and wait for blindness?

What about stem cell treatment? I've read that stem cell treatment can be used for optic nerve damage. Can't it be used for optic nerve drusen to prevent the condition from worsening?

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    • Protein pockets that build up in the optic disc can cause vision issues.
      By: Alila Medical Media
      Protein pockets that build up in the optic disc can cause vision issues.
    • Calcified optic nerve drusen can cause vision problems.
      By: arztsamui
      Calcified optic nerve drusen can cause vision problems.
    • Eye drops may help to relieve intra-ocular strain for patients with optic nerve drusen.
      By: apops
      Eye drops may help to relieve intra-ocular strain for patients with optic nerve drusen.
    • A CT scan may be conducted to diagnose optic nerve drusen.
      By: Tyler Olson
      A CT scan may be conducted to diagnose optic nerve drusen.
    • A slit-lamp device is used to look for optic nerve drusen during a fundoscopy.
      By: Monkey Business
      A slit-lamp device is used to look for optic nerve drusen during a fundoscopy.
    • Damage to the optic nerve is usually progressive.
      By: iko
      Damage to the optic nerve is usually progressive.