76-year-old woman was seen in the office on 3/18/2011. I was awaiting records from Bascom Palmer but unfortunately the patient was seen there a long time ago and we could not obtain them. She had cataract surgery in 2003. She said her vision has not been very good since the 1970s. She said she was told she had optic atrophy at Bascom Palmer in the 1970s. She does not know if she has optic atrophy in her family. VISUAL ACUITY: Vision OD is 20/400, PH 20/200; OS is 20/400, PH 20/200. She does not have her glasses with her. IOP: 18 in both eyes. Color is 0 out of 14 correct. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes with open capsules. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. The nerve is pale and small. OS: Vertical C/D ratio is 0.1. The nerve is pale and small. IMPRESSION: 1. OPTIC NERVE HYPOPLASIA – BOTH EYES 2. POSSIBLE DOMINANT OPTIC ATROPHY DISCUSSION: I explained to the patient her maculae look normal and the retinas look fine, but her optic nerves do look small and pale. I suspect she may have a variant of dominant optic atrophy. I was unsuccessful in obtaining her old records. Given that it is a long-standing problem, I do not know that it necessarily needs to be evaluated further at this point. She could see one of the neuro-ophthalmologists in the area at some point in the future.