TY - CHAP M1 - Book, Section TI - Chapter 21. Abnormal Optic Nerve A1 - Lueder, Gregg T. Y1 - 2011 N1 - T2 - Pediatric Practice: Ophthalmology AB - Table Graphic Jump Location|Download (.pdf)|PrintThe ProblemThe optic nerve is abnormalCommon CausesOptic nerve hypoplasiaPapilledemaOptic nerve colobomaGlaucomaOther CausesPseudopapilledemaMyelinated nerve fibers AlbinismKEY FINDINGSHistoryOptic nerve hypoplasiaIf bilateral, often presents with poor vision and abnormal eye movements in infancyUnilateral hypoplasia may be associated with strabismus due to decreased visionIf pituitary dysfunction, may have poor growth, developmental delay, and abnormal stress responsePapilledemaHeadacheDouble visionTransient visual obscuration (brief episodes of dimmed vision)Idiopathic intracranial hypertensionFrequently associated with medication in childrenCorticosteroids, retinoic acidAlso associated with obesityOptic nerve colobomaAbnormal pupil appearance (if iris coloboma present)Poor vision or strabismus if fovea affectedAssociated systemic diseasesCHARGE AssociationGlaucomaMay have family historyInfants and young children Light sensitivityEye appears large, cornea cloudyOlder childrenUsually asymptomaticPseudopapilledemaOptic disc drusenTrisomy 21FarsightednessMyelinated nerve fibersDecreased vision due to myopiaExaminationOptic nerve hypoplasiaInfant with poor vision, nystagmusPoor pupil responsesPapilledemaVisual acuity usually normal (unless severe)Optic nerve elevated, swollen, hemorrhages, cotton wool spotsDecreased outward movement of eye due to sixth nerve palsyOptic nerve colobomaMay have associated iris colobomaVariable involvement of optic nerve, retinaUsually inferonasal quadrantGlaucomaInfants and young childrenCorneal clouding, eye larger than normalUsually unable to visualize optic nerveOlder childrenEnlarged cup:disc ratioPseudopapilledemaTrisomy 21—abnormal vascular patternOptic nerve drusenIrregular lumpy appearanceWhite deposits within nerveMyelinated nerve fibersWhite feathery appearance beginning at optic nerveExtend along course of retinal nerve fibers SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=56150718 ER -