Optic Nerve Damage

What Is Optic Nerve Damage?

The optic nerve transmits information from the eye to the brain, making it the direct connection between the retina and the brain area that processes what is seen. The nerve cells that make up the optic nerve are sensitive cells, and damage to the optic nerve can be irreversible. Various diseases, inflammation, or pressure can damage the nerve cells, disrupting the transmission of information.

What Diseases or Injuries Can Damage the Optic Nerve?

Damage to the optic nerve can have very different origins. The most common causes of impaired vision due to damaged optic nerve fibers are increased intraocular pressure, technically known as glaucoma, and diabetic retinopathy. Glaucoma is associated with bruising of the nerve fibers due to increased eye pressure. The increased intraocular pressure can develop slowly and steadily so that in some cases, damage to the optic nerve is only detected late and only becomes apparent when the vision is impaired with visual field loss. If visual disturbances occur, the damage may already be very advanced. Diabetic retinopathy, on the other hand, develops in patients with poorly controlled diabetes due to long-term high blood sugar levels. The high sugar levels in the blood can damage the small vessels in the eye, subsequently leading to reduced blood flow to the retina and optic nerve. An inflammation of the optic nerve, medically called optic neuritis, can also be associated with damage in the worst case. The inflammation is noticeable by decreased vision and painful eye movement and can be associated with multiple sclerosis.

Increased intracranial pressure leads to a congested papilla and edema in the area where the optic nerve enters the retina. This can damage the fibers if it persists for a long time. However, eye tumors can also cause loss of optic nerve fibers due to pressure on the nerve.

Similarly, vascular occlusions can cause a lack of oxygen and nutrient supply to the nerve, which is why neurons die and subsequently cause visual loss. Vascular occlusions occur mainly due to vascular calcification and fatty degeneration, heart diseases, and strokes. Genetic causes with incomplete formation of the optic nerve can also be causative of the limited functionality of the nerve.

How Is the Optic Nerve Examined?

To examine the nerve, ophthalmologists use the slit lamp, which makes it possible to look at the back of the eye. In addition, the optic nerve disc, the point at which the optic nerve enters the retina, can be assessed while examining the eye fundus. This may reveal, for example, color variations or changes in shape that may indicate a possible disease process. In some cases, it may be necessary to perform imaging procedures such as computed tomography. In addition, examinations of visual acuity, color vision, and the visual field are performed. A determination of the intraocular pressure is also essential for the detection of glaucoma.

Which Therapy Methods are Available?

Depending on the clinical picture, there are different therapy options. For example, in the case of glaucoma, it is important to lower the intraocular pressure immediately. Otherwise, irreversible damage to the optic nerve may occur. Here, a therapy with eye drops to reduce and improve the outflow of the aqueous humor or laser therapy can be applied. Inflammation of the nerve is also treated with medication, usually with steroids. To prevent diabetic retinopathy, on the other hand, early treatment of diabetes and blood sugar control are of central importance, and regular ophthalmological check-ups should also be carried out.

Can the Optic Nerve Regenerate?

If there is a complete loss of the optic nerve due to the loss of the optic nerve fibers, regeneration is impossible because the neurons cannot form new ones. In patients with residual vision, treatment with alternating current, for example, can be used to improve some functional limitations. Due to the nerve fibers' lack of regenerative capacity, it is essential to detect a possible disease process of the optic nerve at an early stage. Appropriate preventive examinations should be performed regularly, especially for diabetics and for the detection of glaucoma.

Which Doctors and Clinics are Specialists?

Optic nerve examinations are performed by ophthalmologists or in ophthalmology clinics. In outpatient settings, ophthalmologists or specialized centers for ophthalmology, treatment is usually carried out.

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on a doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in optic nerve damage and are awaiting your inquiry or treatment request.

Sources:

• Augenheilkunde. Lang G, Esser J, Gareis O, Lang G, Lang S, Spraul C, Wagner P, Hrsg. 6., überarbeitete Auflage. Stuttgart: Thieme; 2019. doi:10.1055/b-006-163269
• www.bsvt.at/glossary/opticusatrophie-sehnervschaedigung/
• www.augentagesklinik-oberland.ch/augenarzt/sehnerv-erkrankungen/
• www.augenaerzte-in-duesseldorf.de/leistung/diagnose-und-therapie/sehnerverkrankungen/