Disc Drusen- Don’t Forget!
March 8, 2009
I had a patient who I was following for a couple of years as a glaucoma suspect- she a had slightly elevated IOP’s in the low 20’s with thin corneas and the visual field showed a classic arcuate. The discs had mild cupping, and in hindsight, should have been a red flag that something was not quite right, as the cupping did not seem to correlate with the field, especially since the field defect was unilateral. I put her on Timoptic and her visual field remained perfectly stable. Then, for unrelated reasons, she needed a head CT, and sure enough- the radiologist found optic nerve head drusen. Now it all made more sense- she never had glaucoma at all. I took her off the Timoptic and she is doing fine. I now try to have a low threshold for getting a CT scan of the discs when I see unilateral glaucoma and the discs just don’t seem to jibe with the field, even when there are plenty of risk factors like high IOP and thin corneas.
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3 Responses to “Disc Drusen- Don’t Forget!”
I’m an OD student. I also happen to ONH drusen so I have a heightened appreciation for it. I know a CT will pick up the calcium deposits, but wouldn’t an easier in office procedure be a B-scan?
drusen of the optic nerve does not cause progression of visual field loss. it is always stable, decade after decade. if she is going blind, it is because of the glaucoma, and unless the glaucoma is very, very advanced, pressure-lowering surgery will typically slow it down enough to save the vision. research into drusen is not the way to go here.
before accepting a verdict of blindness, be sure to get a 2nd opinion.
my mother was just diagnosed with glaucoma with drusen of the optic nerve. they told her she has calcium deposits on her optic nerves and going blind is the inevitable. she is only 54. i can’t seem to find much information or resources online about her condition, everything i have found is 4-5 years old including this post, if you get this any help would be so appreciated. thank you
