Coloboma of optic papilla
Overview
Coloboma of optic papilla: A hole in the eye structure called the optic disc which is located at the head of the optic nerve. Severity of symptoms is determined by the size of the defect.
Symptoms
The list of signs and symptoms mentioned in various sources for Coloboma of optic papilla includes the 1 symptoms listed below: * Impaired vision
Causes
* Pseudotumor cerebri –Other symptoms: Headache, nausea, and vomiting all worse in morning, transient visual obscurations, diplopia –Diagnosis includes increased ICP, normal imaging, normal CSF –More common in obese females * Optic neuritis –May be associated with postviral syndromes or meningoencephalitis –Loss of vision, pain on eye movement –Vision usually improves within a few weeks, but not full recovery * Optic neuropathy –Compressive: Associated with NF1 and optic nerve glioma, presents with progressive visual loss, strabismus, nystagmus, proptosis –Infiltrative: From cancers (leukemias, lymphomas), infection, or inflammation (sarcoidosis, TB, toxocariasis, toxoplasmosis, CMV); optic disc swelling, vision loss, and hemorrhages –Toxic/nutritional optic neuropathy: Symmetric neuropathy from nutritional deficiency (thiamine, B12), drugs (tobacco/alcohol, chloramphenicol, rifampin), toxins (lead, methanol); visual field and vision loss; may recover with treatment –Leber optic neuropathy: Mitochondrial DNA transmission, presents late teens to middle 20s; visual field and vision loss, may spontaneously improve * Increased ICP: Idiopathic intracranial hypertension, intracranial hemorrhage, space-occupying lesion * Growth hormone supplementation * Retinal hemorrhage and loss of vision * Retinal vein occlusion * Malignant hypertension: Associated with retinal hemorrhage, exudates, and cotton wool spots * Optic neuropathy, nonarteritic or arteritic * Demyelinating disease * Infectious conditions: Toxoplasmosis, Lyme disease, Bartonella; hard exudates may be visible funduscopically
Diagnosis
These home medical tests may be relevant to Coloboma of optic papilla: * Vision and Eye Health: Home Testing: * Home Eye Tests * Home Vision Tests
Treatment
* Condition-dependent: Treatment of underlying systemic disease is often the only treatment * Pseudotumor cerebri and other causes of intracranial hypertension: Weight loss, Diamox or Lasix, planned recumbency, LP shunt or optic nerve sheath fenestration if loss of visual function * Space-occupying lesion or hemorrhage: Neurosurgical intervention * Meningoencephalitis: IV antibiotics * Infectious optic neuropathy: Treat underlying cause and consider systemic steroids (controversial) * Optic neuritis: IV (not oral) steroids * Optic nerve glioma treatment controversial: Observation if slowly progressive, resection if only one nerve involved, radiation if chiasm involved, shunts if increased ICP * Toxic or nutritional: Stop offending toxin or supply nutritional supplementation