What Is Optic Atrophy?

Medically Reviewed by Jabeen Begum, MD on August 24, 2022
Written by Sarah Vallie
4 min read

Vision loss is scary, and it can have many different causes. Sometimes, vision loss is caused by a condition called optic atrophy. 

Optic atrophy is a condition in which the optic nerve begins to deteriorate. The optic nerve is the nerve at the back of your eye that connects your eye to your brain, allowing you to see.

There are a couple of different optic atrophy types. Optic atrophy is often a symptom rather than its own disease, and there are also a few different types of hereditary optic atrophy. These can include: 

  • Dominant optic atrophy, also called Kjer’s optic atrophy or optic atrophy type 1, which can cause slowly worsening vision beginning in childhood.
  • Optic atrophy 2, also called early-onset x-linked optic atrophy, which is a very rare form of optic atrophy that causes vision loss and some neurological conditions in males.
  • Autosomal dominant optic atrophy and cataract, also called autosomal dominant optic atrophy type 3, which causes vision impairment due to a range of problems within the eyes, including cell loss, cataracts, and optic atrophy.
  • Costeff syndrome, also called autosomal recessive optic atrophy 3, which causes vision loss as a result of optic atrophy and also may cause delayed development and motor problems.
  • Leber’s optic atrophy, also called Leber’s optic neuropathy, which is a condition passed through mitochondrial DNA and results in loss of vision.

Optic atrophy is caused when something is interfering with the optic nerve’s ability to send signals to the brain. Aside from hereditary conditions, a few other things can cause optic atrophy.

Ischemic optic neuropathy. Ischemic optic neuropathy is a condition that causes sudden vision loss due to a lack of blood flow to the optic nerve. Ischemic optic neuropathy is most common in people age 50 and older. Risk factors for ischemic optic neuropathy include:

  • High cholesterol
  • High blood pressure
  • A sudden drop in blood pressure or blood loss
  • Swollen arteries in the head
  • Clogged arteries
  • Heart disease
  • Diabetes
  • Sleep apnea
  • Smoking
  • Migraines
  • Glaucoma

Glaucoma. Glaucoma is an umbrella term for a group of conditions that damage the optic nerve. Often, these conditions inflict damage by causing too much pressure in your eyes. Glaucoma tends to run in families, and there are a few types, including:

  • Open-angle glaucoma, the most common form, caused by a buildup that prevents proper drainage of the eyes
  • Angle-closure glaucoma, caused by the iris bulging forward and creating blockage that prevents proper drainage
  • Pigmentary glaucoma, caused by pigment granules in the iris creating blockage that prevents proper draining
  • Normal-tension glaucoma, glaucoma that occurs despite normal eye pressure
  • Glaucoma in children, which can be caused by drainage blockages or another medical condition

Anterior ischemic optic neuropathy. Anterior ischemic optic neuropathy is a stroke of the optic nerve. This can be caused by: 

  • Inflammation of the arteries that supply blood to the optic nerve
  • Narrowed arteries
  • Decreased blood flow to the optic nerve
  • A drop in blood pressure that affects the blood supply to the optic nerve
  • Increased blood thickness
  • Increased pressure inside the eye 

Multiple Sclerosis. Multiple sclerosis is an autoimmune disease that results in your immune system attacking the nerve fibers of the central nervous system. The central nervous system is made up of the brain and spinal cord. MS can also cause swelling of the optic nerve called optic neuritis, which may lead to optic atrophy.

Other conditions that may cause optic atrophy include a tumor pressing on the optic nerve or improper formation of the optic nerve in utero.

Symptoms of optic atrophy all involve vision loss. This may include:

  • Reduced sharpness in vision
  • Blurred vision
  • Impaired peripheral vision
  • Difficulties distinguishing color

The symptoms of optic atrophy are very similar to the symptoms of many other eye problems. If you experience these symptoms, contact your ophthalmologist right away. 

If  your doctor suspects that optic atrophy is the cause of your symptoms, they will likely perform an exam with a tool called an ophthalmoscope. An ophthalmoscope contains lights and lenses that allow the ophthalmologist to look into your eyes. 

A tell-tale sign of optic atrophy is a pale optic disc. The optic disc is the area around the optic nerve where the nerve enters the eye. In cases of optic atrophy, the optic disc will become pale due to a lack of blood flow.

If your doctor suspects that your optic atrophy is due to a tumor or multiple sclerosis, they may have you undergo an MRI.

Unfortunately, there isn’t really a cure for optic atrophy, which is why it's so important to have regular eye checkups.

When treatment is possible, it is often an indirect result of being able to treat the cause of the optic atrophy.

Glaucoma. Damage caused by glaucoma is irreversible. If it is caught early enough, though, your doctor may be able to treat the glaucoma and slow or prevent permanent vision loss. Treatments for glaucoma include eye drops, medications, laser treatment, surgery, or a combination of these methods.

Anterior Ischemic Optic Neuropathy. Treatment of an optic nerve stroke usually involves treatment of the factors that led to the stroke. This may include the management of cardiovascular disease or giant cell arteritis, a condition that causes inflamed arteries and requires corticosteroid therapy.

Multiple Sclerosis. There is no cure for multiple sclerosis. Treatment involves managing symptoms and slowing the disease’s progression through medication and physical therapy. Sometimes, optic atrophy occurs due to MS causing optic neuritis, a condition that causes swelling that damages the optic nerve. In this case, vision may return if the inflammation goes away.

If you experience unexpected vision loss, contact your doctor right away. Vision loss can have many causes, and it’s important to find the cause so treatment can begin. Timely treatment of vision loss, including optic atrophy, may keep you from losing your vision entirely.