7-12 & 7-13 Optic Disc

Glaucomatous cupping

- caused by increased intraocular pressure within the eye leads to increased cupping (backward depression of disc) and atrophy. Base of the enlarged cup is pale appearance: death of optic nerve fibers leads to loss of the tiny disc vessels

papilledema

- elevated intracranial pressure causes intraaxonal edema along the optic nerve, leading to engorgement and swelling of the optic disc appearance: color is pink, hyperemic, often with loss of venous pulsations, disc vessels are more visible, more numerous, and curve over the borders of the disc. the disc is swollen with lines blurred. the physiologic cup may not be visible. seen in intracranial mass, lesion, or hemorrhage meningitis

normal optic disc

- tiny disc vessels give normal color to the disc Appearance: color yellowish orange to creamy pink, disc vessels are tiny, disc margins are sharp. physiologic cup is located centrally or somewhat temporally. It may be conspicuous or absent. Diameter <50% of the disc

physiologic cupping

The physiologic cup is a small whitish depression in the optic disc, the entry point for the retinal vessels. Although sometimes absent, the cup is usually visible either centrally or toward the temporal side of the disc. Grayish spots are often seen at its base.

Medullated Nerve fibers

much less common, but dramatic finding; appearing as white patches with feathered margins. they obscure the disc edge and retinal vessels.

rings and cresents

often seen around the optic disc; developmental variations that appear either as white sclera, black retinal pigment, or both especially along the temporal border of the disc.

optic atrophy

physiologic cup is enlarged, occupaying more than 50% of the disc's diameter, at time extending to the edge of the disc. retinal vessels sink in and under the cup and may be displaced nasally appearance: color white, tiny disc vessels absent, seen in optic neuritis, MS, and temporal arteritis