Optic Nerve Damage

Medically Reviewed By William C. Lloyd III, MD, FACS

What is optic nerve damage?

Optic nerve damage is any kind of injury or damage to the optic nerve, including trauma, inflammation, disease or deterioration. Optic nerve damage is also called optic nerve atrophy or optic neuropathy. The optic nerve is the nerve that connects and transmits information between the eye and the brain. Optic nerve damage can lead to vision distortion, vision loss, and blindness.

Within the eye, there are many elements that work together to create vision. Light flows through the cornea and the pupil into the lens before it is projected onto the retina in the back of the eye. The retina transforms light into electrical impulses that are transmitted by the optic nerve to the brain. The eyes are protected by the bones of the orbit and move through the actions of the eye muscles, which are controlled by nerves.

A variety of diseases, disorders and conditions originating most often in the eye and the nervous system can lead to optic nerve damage. Optic nerve damage can result from:

  • Compression of the optic nerve

  • Glaucoma, or high pressure within the eye

  • Infection

  • Inflammation

  • Interruption in blood circulation to the optic nerve

  • Malignancy (cancer)

  • Trauma

The only way to detect optic nerve damage is through a comprehensive eye examination. Seek prompt and regular eye care throughout your life, as recommended by your physician or healthcare provider, to best detect and treat underlying conditions in their earliest stage, reduce the risk of serious complications, and preserve your vision.

In some cases, the underlying cause of optic nerve damage is a medical emergency that poses an immediate threat to your vision or your life if not diagnosed and treated rapidly. These include stroke, cerebral aneurysm, serious head injury, and acute angle-closure glaucoma, which can quickly lead to total loss of sight. Seek immediate medical care (call 911) if you, or someone you are with, have any symptoms of these conditions, including sudden vision loss, halos around lights, or other vision distortion; severe eye pain; sudden, severe headache, confusion or disorientation; slurred speech; inability to move a part of the body; or passing out.

What symptoms might occur with optic nerve damage?

Common symptoms of optic nerve damage include vision distortion, loss of vision, eye redness, and pain when moving the eye. These symptoms may also be present with a variety of other eye conditions, so a proper diagnosis by a qualified medical professional is needed.

In some cases, there may not be any symptoms of optic nerve damage or the conditions that can lead to optic nerve damage. That is why it is important that you have regular eye examinations throughout your lifetime to best ensure early detection and treatment of eye conditions and to minimize the risk of permanent damage to the eye and vision.

Eye and vision symptoms of optic nerve damage

Optic nerve damage can cause symptoms that affect the eyes and your vision, which may occur in one or both eyes including:

  • Abnormal pupil size and nonreactivity to light
  • Bulging of the eyes

  • Complete or partial loss of vision

  • Diminished ability to see fine details

  • Diminished color vision or colors seem faded

  • Dimming or blurring of vision

  • Double vision

  • Eye redness

  • Impaired reaction of the pupil to light or dilated pupil

  • Involuntary movement of the eyes

  • Seeing blind spots in your peripheral vision

  • Seeing rainbows or halos

  • Severe eye or brow pain or pain when moving the eye

Other symptoms of underlying causes of optic nerve damage

Symptoms of optic nerve damage may also occur with symptoms felt outside the eyes. For example, optic nerve damage due to a stroke may occur along with memory loss and difficulty understanding speech. Other symptoms may include:

Symptoms that might indicate a serious or life-threatening condition

In some cases, the symptoms of optic nerve damage might indicate a life-threatening condition or a serious condition that can permanently affect your vision. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

  • Abnormal pupil size and nonreactivity to light
  • Acute bulging of the eyes (caused by pus or bleeding)
  • Change in level of consciousness, lethargy, unresponsiveness, or passing out
  • Change in mental status, such as confusion or disorientation
  • Facial droop
  • Severe eye pain, which may be accompanied by eye redness
  • Sudden difficulty speaking, slurred speech, or understanding speech
  • Sudden loss or distortion of vision, such as double vision or halos around lights

What causes optic nerve damage?

Vision distortion and other problems with vision that are symptoms of optic nerve damage may be mild when they first begin. Despite this, optic nerve damage is a critical neurological condition that is caused by a serious underlying disease or condition.

Problems with blood vessels that can cause optic nerve damage

Certain types of diseases or conditions of blood vessels can cause optic nerve damage including:

  • Anterior ischemic optic neuropathy (stroke of the eye caused by diminished blood flow to the arteries that supply blood to the optic nerve)

  • Blood clot that obstructs an artery that supplies blood to the optic nerve

  • Cerebral aneurysm (life-threatening bulging and weakening of the wall of an artery that can burst and cause severe hemorrhage)

  • Stroke

  • Subarachnoid hemorrhage (type of bleeding around the brain)

  • Temporal arteritis or giant cell arteritis (inflammation of blood vessels in the head)

Cancer and tumors that can cause optic nerve damage

Certain types of cancer and tumors can cause optic nerve damage including:

  • Circumpapillary metastasis with optic neuropathy (cancer in another part of the body that spreads to the eye and affects the optic nerve)
  • Optic nerve melanocytoma (tumor of the optic nerve that is usually noncancerous)
  • Optic nerve sheath meningioma (tumor of the sheath that covers the optic nerve)
  • Orbital tumors that press on the optic nerve (benign and malignant)

Other causes of optic nerve damage

A variety of other underlying diseases, disorders and conditions can cause optic nerve damage including:]

  • Alcohol abuse during pregnancy (damages the optic nerve of the developing fetus)
  • Exposure to toxic substances, such as arsenic, lead, thallium, methyl alcohol (methanol or wood alcohol), and tobacco
  • Glaucoma (condition in which fluid pressure builds up in the eye, including narrow angle glaucoma and acute angle glaucoma)
  • Graves’ disease (type of hyperthyroidism resulting in excessive thyroid hormone production)
  • Head or eye trauma
  • Hereditary or developmental anomalies, such as the failure of the optic nerve to develop normally
  • Medications (see below)

Medications that can cause optic nerve damage

Drugs implicated in causing optic nerve damage include:

  • Amiodarone (Cordarone)

  • Cancer chemotherapies

  • Digoxin (Lanoxin)

  • Disulfiram (Antabuse)

  • Ethambutol (Myambutol)

  • Isoniazid (Nydrazid or INH)

  • Nonsteroidal anti-inflammatory drugs (NSAIDS)

  • PDE-5 inhibitors, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)

This is not a complete list of medications that are implicated in causing optic nerve problems. Always discuss your complete medication history with your healthcare provider.

What are the potential complications of optic nerve damage?

Complications associated with damage to the optic nerve are serious. You can minimize the risk of serious complications by following the treatment plan you and your healthcare professional design specifically for you. Complications of optic nerve damage include:

  • Brain damage from encephalitis, brain tumor, or hemorrhage

  • Decreased quality of vision

  • Disability

  • Permanent blindness

  • Poor quality of life
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
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