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Key Features

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  • Optic nerve function is evaluated by checking visual acuity, color vision, pupillary response, and visual fields

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Clinical Findings

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  • Poor optic nerve function results in decreased central or peripheral vision, decreased color vision, strabismus, and nystagmus

  • Optic nerve disorders can be due to congenital malformation, malignancy, inflammation, infection, metabolic disorders, and trauma

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Diagnosis

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  • The swinging flashlight test is used to assess function of each optic nerve

    • Shining a light alternately in front of each pupil checks for an afferent pupillary defect or Marcus Gunn pupillary defect

    • An abnormal response in the affected eye is pupillary dilation when the light is directed into that eye after having been shown in the other eye with its healthy optic nerve

  • Optic nerve is evaluated as to size, shape, color, and vascularity

  • Occasionally, myelinization past the entrance of the optic nerve head occurs; appears white, with a feathered edge

  • Myelinization onto the retina can be associated with myopia and amblyopia

  • Anatomic defects of the optic nerve include colobomatous defects and pits

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Treatment

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  • Management of the underlying condition

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