What are optic disc drusen?

The optic nerve is the nerve that connects the eye to the brain. It sends the “picture” taken by the eye to the brain. The optic disc is the part of optic nerve that can be directly seen by the eye doctor on an examination. Optic disc drusen are calcified deposits in the optic disc that may be detected directly on exam or by testing with cameras or ultrasound.  They are present in about 2% of the population. 

What causes optic disc drusen and why are they important?

Optic disk drusen are present from birth, but often go undetected until later in life. Usually they cause no problem, but they may crowd the nerve fibers in the optic nerve. The crowded optic nerve may be predisposed to blood vessel blockage later in life, especially with hardening of the arteries. The condition of blocked blood supply to the optic nerve is called ischemic optic neuropathy (ION). Sleep apnea may play a role in some patients and SSRI anti-depressants may be a risk factor for ION.

Sometimes, optic disc drusen can cause loss of side vision as in glaucoma. In this case, eye drops are sometimes prescribed. Rarely, bleeding under the retina may occur due to blood vessel growth (similar to wet macular degeneration). In that instance, medicine injections or laser may be used.

Finally, optic disc drusen may be buried in the optic disc and the appearance may resemble optic disc edema (papilledema). True papilledema is caused by elevated pressure in the brain. It is, therefore, important to make a correct diagnosis. Although a number of tests may be used, optical coherence tomography (OCT) is the single most reliable test for diagnosis.

How are optic disc drusen managed?

Most cases of optic disc drusen cause no problems and require no treatment. There is no accepted method to remove them. The usual recommendations to prevent hardening of the arteries may be helpful to avoid ION (avoid tobacco and control weight, blood pressure, cholesterol and blood sugar). In order to detect early changes in the vision, it may be helpful to monitor the vision each week with an Amsler grid test. If a sudden blind spot or distortion (straight lines look wavy or crooked) is detected, contact the eye doctor within 2-3 days for evaluation and management.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Copyright  © 2019-2023 Designs Unlimited of Florida.  All Rights Reserved.