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Color of optic nerve in children
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Color of optic nerve in children

My one year old niece recently went to an optomitrist.  He informed my sister and mother that the color of one of her optic nerves was an abnormal color and refered her to an opthamologist.  He said he wasn't sure what that could mean because she appears to see fine.  Of course she cant read so he really couldn't tell much.  We are so worried, and would like to know what this could mean.
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I am an board certified ophthalmologist, although not the forum physician. The optic nerve normally has a pink-orange color. The most common serious "color" problem is optic nerve atrophy where the nerve starts to look pale and white. There are a variety of causes although in a one year old the most common causes would be a congential optic atrophy, poor development (hypoplasia) of the optic nerve, or other developmental problem (toxoplasmosis, toxocara canis, retinal coloboma) . In most instances the cause of the difference in color can be totally harmless. For example sometimes whitish material called glia tissue or myelin can remain on the optic nerve from when the nerve was developing, sometimes the nomal pigment of the retina is not present around the optic nerve (coloboma, conus) and it can make the optic nerve look whiter than normal.

The child needs to be seen by a pediatric ophthalmologist or a comprehensive ophthalmologist with experience in pediatrics. There is more of a chance that this is a harmless or benign problem rather than a serious sight threatening condition---BUT it needs to be checked soon.

Please remember the main cause of loss of vision in American children is amblyopia.  Amblyopia, sometimes incorrectly called "lazy eye" (an inexact term also applied to droopy eyelid or externally wandering eye) is an eye that does not see normal. Amblyopia occurs in 2% of American children but in offspring or relatives of people with amblyopia the incidence is about 20%. Infants with obvious vision problems, crossed eyes, droopy eyelides, "jumping eyes" (nystagmus), white pupil reflex need to be seen immediately by a pediatric ophthalmologist. ALL children should be examined by an optometrist, ophthalmologist between age 3 and 4 to check for amblyopia. Unfortunately only a minority of children are seen for an eye exam when this young. Amblopia is often discovered for the first time when children start first grade. At that age amblyopia is often difficult to treat (treated with glasses and eye occlusion therapy).

JCH MD Board Certified Ophthalmologist
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