Which statement is true about optic nerve atrophy?

Which statement is true about optic nerve atrophy?

• A. It always leads to complete blindness
• B. It can result from glaucoma, PRA, optic neuritis, trauma, or orbital disease
• C. It never causes vision loss
• D. It responds well to steroid therapy

Answer: (B)

Optic nerve atrophy is the irreversible loss of optic nerve fibers, which shows up as pallor of the optic disc and varying levels of vision loss depending on how much nerve has been damaged. Because many things can injure or disrupt the nerve pathway, it can arise from a wide range of causes: glaucoma (optic nerve damage from high pressure), progressive retinal degeneration such as PRA (which lowers retinal input and can lead to retrograde nerve damage), optic neuritis (inflammation that damages the nerve), trauma, or orbital disease (compressive or inflammatory processes affecting the nerve). This broad range of possible causes is why the statement listing glaucoma, PRA, optic neuritis, trauma, or orbital disease as potential sources of optic nerve atrophy is true. It’s not accurate to say it always leads to complete blindness; the amount of vision loss depends on how much of the nerve is damaged and the underlying cause, so some patients retain useful vision. Conversely, it does cause vision loss—so saying it never causes vision loss isn’t correct. Steroid therapy isn’t a reliable cure for established atrophy; steroids may help in some acute inflammatory or compressive conditions, but once atrophy has developed, steroids don’t reverse it.

Optic nerve atrophy is the irreversible loss of optic nerve fibers, which shows up as pallor of the optic disc and varying levels of vision loss depending on how much nerve has been damaged. Because many things can injure or disrupt the nerve pathway, it can arise from a wide range of causes: glaucoma (optic nerve damage from high pressure), progressive retinal degeneration such as PRA (which lowers retinal input and can lead to retrograde nerve damage), optic neuritis (inflammation that damages the nerve), trauma, or orbital disease (compressive or inflammatory processes affecting the nerve). This broad range of possible causes is why the statement listing glaucoma, PRA, optic neuritis, trauma, or orbital disease as potential sources of optic nerve atrophy is true.

It’s not accurate to say it always leads to complete blindness; the amount of vision loss depends on how much of the nerve is damaged and the underlying cause, so some patients retain useful vision. Conversely, it does cause vision loss—so saying it never causes vision loss isn’t correct. Steroid therapy isn’t a reliable cure for established atrophy; steroids may help in some acute inflammatory or compressive conditions, but once atrophy has developed, steroids don’t reverse it.