Optic atrophy refers to degeneration of the optic nerve that results in changes to the optic disc. There are several types of optic atrophy including primary, secondary, consecutive, and glaucomatous. Primary optic atrophy is due to disease proximal to the optic disc with no evidence of previous inflammation and can be caused by conditions like multiple sclerosis. Secondary optic atrophy, also called post-neuritic, presents with a dirty gray colored disc and blurred margins. Consecutive optic atrophy occurs due to retinal or choroidal diseases and shows a waxy pallor of the disc.

1. Optic Atrophy
Dr. K. Srikanth M.S;DO;DNB;

2. Optic atrophy
• Denotes the condition of the optic disc
following degeneration of the optic nerve.
• Classified as;
• Primary optic atrophy
• Secondary optic atrophy
• Conscequtive optic atrophy
• Glaucomatous optic atrophy

3. Primary optic atrophy
• When the atrophy is due to disease proximal to the
disc so there is NO evidence of previous
inflammation.
• CAUSES: Multiple sclerosis
• Space occupying lesions
• Syphilis

4. Clinical features
• Disc is white
• Margins well defined
• Lamina cribrosa seen
• Retina looks normal
• Cupping is shallow

5. Secondary optic atrophy
• Also called post neuritic optic atrophy
• Clinical features:
• Dirty gray colour of the disc
• Margins may be ill defined
• Cup may be obliterated
• Retina may show some evidence of disease

6. Consecutive optic atrophy
• Is a consequence of retinal or choroidal
disease.( Retinitis pigmentosa, Choroidiris,)
• Disc shows a waxy pallor
• Edges are less well defined
• Retinal vessels are contracted

7. Toxic optic Neuropathy
• Is a consequence of Chronic alcohlol
intake,Smoking and with poor nutrition.
• There may be a sudden painless loss of vision
• Usually bilateral
• Disturbed colour perception
• Centro caecal- scotoma

8. causes
• Tobacco, Methyl alcohol, Ethyl alcohol
• Chloroquine, Hydroxy chloroquine,Ethambutol
• Amiadarone, oral contraceptives

9. Treatment
• Prevention
• Nutrition supplement
• Weaning away from alcohol, smoking
• Rehabilitation

10. Re cap

11. Differences
Feature primary secondary conscequtive
colour Chalk white Gray(Dirty) white Waxy pallor
cup shallow Filled up Normal
vessels normal Normal/ attenuated Grossly thinned out
Margins Well defined Blurred Well defined