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Large Optic Nerve
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Large Optic Nerve

I bought my 12 yr old to the eye doctor for a check up yesterday becuase she was complaining of blurry vision durning the exam the doctor said he wanted to run further test and pictures of her Optic Nerve becuase it is large and has never seen it so big in a child and is very concerned he showed me an example of a normal one and of my daughters it was visably large, he wants to retest in 6 month to see if it has grown, The doctor advised one of two things, 1-she was born this way and or 2-she might have something seriouly wrong, is their anything you can expalin to me about the size of the nerve and why the doctor might be concerned,  thank you concerned Mom
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Hi Mom Allison

In a child or infant, little optic nerves are much more serious than large optic nerves. Little optic nerves are called hypoplastic and often do not see well. Small eyes have small optic nerves (hypo-plastic).  Optic nerves (like people) come in different sizes with the average being about 1.5 mm in diameter. So there is a variation in size that occurs in perfectly normal eyes. Larger than normal optic nerves could occur due to myopia, large eyes, buried drusen, abnormal swelling or inflammation (papillitis and papilledma). The optic nerve can appear larger than normal due the coloration around it (conus, retinal pigment showing).

On the other hand he may be referring to the size of the optic cup, which is a depression on the optic nerve that varies from completely flat (no cupping) to totally cupped in end stage glaucoma.

It's very important that the "doctor" telling you this is a physician (ophthalmologist Eye MD) and not a non-physician, limited care provider (optometrist). If you saw an optometrist the first thing I would suggest is that you make an appointment with a comprehensive ophthalmologist or pediatric ophthalmologist right away. Also if you saw an optometrist get copies of your child's eye exam and take that record in to see the ophthalmologist. This is the type of problem that should be evaluated by a Doctor of Medicine (MD).

JCH III MD Disease and Surgery of the Eyes  (Eye MD)

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Thank you  for your help, My child is seeing an ophthalmologist Eye MD but I am not sure if he spoke of the nerve or the cup, I have a call into the office to go over the appointment. I will post  what I find out

Thanks again
Allison G
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