"Crowded optic nerves"

[noiseordinance]

Hey there. Maybe someone can give me some advice. I'm in college and do not have much in the way of insurance (though there is a school clinic that gives you ibuprofin for every condition imaginable; ok, a slight exaggeration). At any rate, I have had vision issues and broke down and got my eyes examined at a local optometrist. My symptoms for doing so involved slight difficulties seeing distance, eye fatigue and light sensitivity. I am 30, and the symptoms have been surfacing over the past year or two.

So I get prescribed -0.50 on both sides; a very light prescription I understand. However, during the eye-health exam and pupil dilation, the optometrist said I have "irritated, abnormal, crowded optic nerves" which may be due to high blood pressure or high cerebral spinal fluid pressure. My blood pressure is typically quite low (sometimes as low as 80/50, but usually about 100/60 range). CSF pressure, on the other hand, is the worrisome culprit. Immediately, my brain starts to wonder towards ideas of meningitis or brain tumors, and the like, though I'm trying my best to keep my worries at bay.

I'm curious if anyone can shed any light to this type of diagnosis, and where to go from here. I plan on visiting my school clinic, but I imagine they won't do anything, or have any advice. I'm not sure if the next step would be seeing an opthamologist or a neurologist, or what I should do. Any advice would be awesome.

[John C Hagan III, MD, FACS, FAAO]

Crowded nerves by definition does not include swelling, inflammation or pathologic elevation.

All is means is that several million nerve fibers are squeezing through an opening smaller than normal. Many of these eyes are farsighted (hyperopic), the greatest number will have no problems at all. (like 3 lanes of traffic narrowing down to two lanes around an accident but still moving).

A small number will have anterior non-arteritic ischemic optic neuropathy. (ANAION) most will not; the converse is also true most people with ANAION will not have crowded disks.

There is nothing you can do about the structure of your optic nerve. Living a healthy lifestyle is the best thing to do (true for all of us).  You should have a good internist or cardiologist evaluate your low blood pressure to see if there is any underlying cause.

JCH MD

[Mummykib28]

My 8 year old has crowded discs in both eyes but has brilliant vision. I'm worried if she bangs her head if damage will be caused.

[JohnHaganMD]

Crowded nerves by definition does not include swelling, inflammation or pathologic elevation.

All is means is that several million nerve fibers are squeezing through an opening smaller than normal. Many of these eyes are farsighted (hyperopic), the greatest number will have no problems at all. (like 3 lanes of traffic narrowing down to two lanes around an accident but still moving).

A small number will have anterior non-arteritic ischemic optic neuropathy. (ANAION) most will not; the converse is also true most people with ANAION will not have crowded disks.

There is nothing you can do about the structure of your optic nerve. Living a healthy lifestyle is the best thing to do (true for all of us).  You should have a good internist or cardiologist evaluate your low blood pressure to see if there is any underlying cause.

Crowded optic nerves does not increase the risk of trauma.

[Puzzlepieces]

I saw your comment to noise ordinance re: the bilateral crowded optic nerves. I've just received the same news from my ophthalmologist, who also sent me for retinal scans (ultrasound and photos). My retina work up was fine, but I still have the issue of the crowded optic nerves. I too have very low blood pressure, typically 100 over 60. Any thoughts?

[John C Hagan III, MD, FACS, FAAO]

You should have been given a better explanation of your problem and referred to an ophthalmologist. Given what you've been told you need to see an eye MD ophthalmologist.  Your health insurance will normally cover this however even if you don't have any health insurance you need to see and Eye MD.   You can find an Eye MD near you at www.aao.org

JCH MD