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43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately. VISUAL ACUITY: Vision OD is 20/80, OS is 20/120. IOP: OD 17, OS 16. SLIT LAMP EXAM: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. The nerve does look small. There is no posterior vitreous separation. OS: Vertical C/D ratio is 0.5. The nerve looks pale and small. There is no posterior vitreous separation. SPECTRALIS SD-OCT SCAN: The nerve fiber layer scans do show nerve fiber layer atrophy. The average thickness in the right eye is 52 microns and the left eye 50 microns. That is about half normal. There is excessive thinning of the temporal aspect of the optic nerve in both eyes. The macular scans also show retinal atrophy concomitant to his optic nerve atrophy. FUNDUS PHOTOGRAPHY: The photos show the nerve to be small. IMPRESSION: 1. OPTIC ATROPHY WITH OPTIC NERVE HYPOPLASIA – BOTH EYES DISCUSSION: I explained to the patient he does look like he has optic nerve hypoplasia. Classically that is not a progressive disease but he is noticing changes. I gave him the name of an excellent low-vision specialist in Tampa. In the meantime, in order to follow the optic nerve to make sure there is no progression, I asked him to return for check in six months for a repeat scan of the nerves.

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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision178 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision95 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision116 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision86 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision53 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision63 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision51 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision46 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision54 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision47 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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Optic Nerve Hypoplasia - 43 Year Old Man - declining vision67 views43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately.
Vision OD is 20/80, OS is 20/120
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43-year-old man was diagnosed with optic nerve hypoplasia at age fifteen at the National Institute of Health. His vision seems to be declining lately. VISUAL ACUITY: Vision OD is 20/80, OS is 20/120. IOP: OD 17, OS 16. SLIT LAMP EXAM: Normal with clear lenses. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. The nerve does look small. There is no posterior vitreous separation. OS: Vertical C/D ratio is 0.5. The nerve looks pale and small. There is no posterior vitreous separation. SPECTRALIS SD-OCT SCAN: The nerve fiber layer scans do show nerve fiber layer atrophy. The average thickness in the right eye is 52 microns and the left eye 50 microns. That is about half normal. There is excessive thinning of the temporal aspect of the optic nerve in both eyes. The macular scans also show retinal atrophy concomitant to his optic nerve atrophy. FUNDUS PHOTOGRAPHY: The photos show the nerve to be small. IMPRESSION: 1. OPTIC ATROPHY WITH OPTIC NERVE HYPOPLASIA – BOTH EYES DISCUSSION: I explained to the patient he does look like he has optic nerve hypoplasia. Classically that is not a progressive disease but he is noticing changes. I gave him the name of an excellent low-vision specialist in Tampa. In the meantime, in order to follow the optic nerve to make sure there is no progression, I asked him to return for check in six months for a repeat scan of the nerves.