| 377 Disorders of optic nerve and visual pathways | |
|---|---|
| eicd10 | 377.14 Glaucomatous atrophy [cupping] of optic disc |
| eicd10 | 377.15 Partial optic atrophy Temporal pallor of optic disc |
| eicd10 | 377.16 Hereditary optic atrophy Optic atrophy: dominant hereditary Leber's |
Overall, 40% of the patients were confirmed to have optic neuritis. However, optic neuritis was misdiagnosed in 60% of the patients; roughly 73 patients. These patients had other diagnoses, such as headaches, eye pain, functional visual loss and other optic neuropathies, including nonarteritic anterior ischemic optic neuropathy.
Those additional symptoms include:
Phases:
Optic atrophy is a sign and typically is noted as optic nerve pallor. This is the end stage of a process resulting in optic nerve damage. Because the optic nerve fiber layer is thinned or absent the disc margins appear sharp and the disc is pale, probably reflecting absence of small vessels in the disc head.
The optic disc pallor may be diffuse or segmental (sectoral). Segmental pallor occurs if part of the blood supply to the optic nerve is occluded, and It will be associated with an appropriate altitudinal field defect. An important treatable cause of ischaemic optic neuropathy is giant cell arteritis (GCA).
Optic atrophy is a condition that affects the optic nerve, which carries impulses from the eye to the brain. (Atrophy means to waste away or deteriorate.) There is no effective treatment for this condition.
Primary optic atrophy, unspecified eye H47. 219 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM H47. 219 became effective on October 1, 2021.
Sectoral or partial optic atrophy It can be temporal or altitudinal disc pallor. Temporal pallor results due to involvement of the papillomacular bundle and commonly seen in toxic, nutritional optic neuropathy. NAION initially presents with disc swelling followed by sectoral disc pallor.
Sometimes the optic nerve can transition from being normal and healthy to having a pale/atrophic appearance. This is referred to as primary optic atrophy....My Patient Has Optic Nerve Pallor: What Do I Do?Primary optic atrophySecondary optic atrophy (Prior history of optic disc edema)TraumaOptic neuritis7 more rows•Feb 27, 2018
Optic nerve atrophy causes vision to dim and reduces the field of vision. The ability to see fine detail will also be lost. Colors will seem faded. Over time, the pupil will be less able to react to light, and eventually, its ability to react to light may be lost.
Optic neuritis is an important cause of optic atrophy. It usually occurs in individuals between 10-50 years of age. Patients typically present with sudden, the usually severe visual loss associated with pain on ocular movements.
Optic atrophy is the final common morphologic endpoint of disease process that causes degeneration of axons of the ganglion cells.
Optic nerve hypoplasia (ONH) is a congenital disorder characterized by underdevelopment (hypoplasia) of the optic nerves. The optic nerves transmit impulses from the nerve-rich membranes lining the retina of the eye to the brain.
Bilateral Optic Atrophy (BOA) is a condition that affects the optic nerve, which carries impulses from the eye to the brain. Characteristics of BOA involve deficits in central vision, difficulties distinguishing contrast, loss of visual acuity, and changes in the color and the structure of the optic disc.
Optic atrophy can occur in cases where the optic nerve did not develop properly. It may also result from inflammation of the optic nerve or from glaucoma when the pressure inside the eye remains too high. In unusual cases, poisons, vitamin deficiencies, or tumors may be responsible.
Optic disc pallor refers to an abnormal coloration of the optic disc as visualized by a fundoscopic examination. The disc normally has a pink hue and a central yellow depression. With optic disc pallor, an abnormal pale yellow color is evident.
Optic atrophy can occur in cases where the optic nerve did not develop properly. It may also result from inflammation of the optic nerve or from glaucoma when the pressure inside the eye remains too high. In unusual cases, poisons, vitamin deficiencies, or tumors may be responsible.
Foster-Kennedy Syndrome is characterized by unilateral visual loss with a compressive optic atrophy in one eye and contralateral papilledema caused by increased intracranial pressure. The same ophthalmoscopic features however can be seen in the pseudo-Foster-Kennedy Syndrome.
In MS, optic neuritis occurs when the immune cells attack the healthy, protective myelin sheath that surrounds the optic nerve, mistaking them for invading cells. This causes the myelin to swell up, which can lead to damage of the optic nerve.
In most cases, it is easy to determine the terms used for ocular diseases and eye complications from the patient history. Nevertheless, the ICD 9 codes describe the symptoms as well which are important to familiarize with:
Eye problems are fairly common and most are minor issues that do not last long. But there are some eye problems that can become serious if left unchecked and can lead to permanent loss of vision. Some of the most common eye problems include:
According to the American Eye Institute, more than 3 million Americans experience chronic eye pain, which means that this condition is quite prevalent. Chronic pain has been identified to be more likely in patients having ocular sensory apparatus dysfunction of neuropathic ocular pain.
This is a fairly common disorder found in people over the age of 50. It is attributed to the thinning of the macula, causing reduced central and blurry vision. The macula is the part of the retina responsible for clear vision in your direct line of sight.
Cataracts are a condition caused when the lens in the eye becomes foggy. The natural eye lens is normally clear, which is crucial for you to see since light passes through the clear lens. The lens is used to focus the light and helps the brain to process the information and form a picture.
Glaucoma consists of a group of eye conditions that damage the optic nerve. The health of the optic nerve is essential for good vision, so once it is damaged, it can lead to impaired vision. The damage is usually caused by abnormally high pressure on the eye. Glaucoma is one of the leading causes of blindness for people over the age of 60.
Dry eye, on the surface, appears to be a simple matter – the result of the eyes not producing the required supply of tears or the result of tears evaporating too soon from the cornea surface. But, as you know, it causes pain and itchiness and could result in inflammation, scars, or ulcers on the cornea.
Management. The management goal is to intervene before optic atrophy is noted or to save remaining function. This will depend on the underlying cause for the optic nerve damage. For instance, intraocular pressure control in glaucoma, control of inflammation in sarcoid, etc.
Optic atrophy is somewhat of a misnomer as atrophy implies disuse, and thus optic nerve damage is better termed optic neuropathy.
This is the end stage of a process resulting in optic nerve damage. Because the optic nerve fiber layer is thinned or absent the disc margins appear sharp and the disc is pale, probably reflecting absence of small vessels in the disc head.
The optic nerve is a bundle of 1.2 million axons of retinal ganglion cells that carries visual information from the retina to the brain. The optic nerve is myelinated by oligodendrocytes that do not regenerate after damage. In optic nerve atrophy there is loss of axons and shrinkage of myelin leading to gliosis and widening of the optic cup.
Optic atrophy refers to the death of the retinal ganglion cell axons that comprise the optic nerve with the resulting picture of a pale optic nerve on fundoscopy. Optic atrophy is an end stage that arises from myriad causes of optic nerve damage anywhere along the path from the retina to the lateral geniculate.
Primary prevention. Optic atrophy is the end stage of a process causing damage to the optic nerve. Medical practice is currently unable to return function (regrow axons) to an atrophic optic nerve, and at best is able to stabilize whatever function remains. Primary prevention (removal of the process causing the damage) is ...
Since the optic nerve is the conduit for information from the retina to the brain, a damaged optic nerve will result in vision loss. Subtle damage might not affect acuity but may lead to a loss of contrast or color vision. Severe damage may lead from legal blindness to no light perception. Damage to a part of the optic nerve results in loss of vision in the corresponding visual field. Occasionally if the process causing damage is removed before apoptosis occurs (as for instance removal of a pituitary tumor compressing the chiasm or reducing inflammation in sarcoid) some improvement in visual function may be noted. A complete diagnosis is based on optic nerve appearance, tests of visual function (visual field, contrast, color, acuity), identifying the causative factor of the damage, and ruling out other causes for vision loss (such as retinal causes).