congenital defect in child's optic nerve

My 6-year old daughter had an eye exam yesterday and we were told that she has a congenital defect in both optic nerves.  Her vision is perfect, but apparently, a healthy optic nerve is a thick band of nerve tissue with a small hole running through where the blood vessels are.  In my daughter's eyes, there is a very thin rim of healthy nerve tissue with a large hole running through.  We were told this puts her at a much higher risk for glaucoma or permanent vision loss due to to nerve damage.  The doctor stressed that neither is inevitable, but that she plans to do regular glaucoma tests and she did take pictures of the optic nerves yesterday.  She also said there is really nothing we can do (other than good nutrition) as preventative measures.  As far as I can tell by the limited research I've done, the only similar thing I come up with is Optic Nerve Hypoplasia, but nothing I've found references a case without some vision impairment.  Could this be something else and is there anything proactive I can do?  Thank you.

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

You should not be speculating on what the problem is and the correct diagnosis, especially if she saw an Eye MD. Call back and get an exact diagnosis. If you are not comfortable get a second opinion from another Eye MD. Find one at www.aao.org

JCH III MD

[MominNC37]

Thank you.  She asked me to gather some family history and when I call her back with that I will ask for her exact diagnosis.

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

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[MominNC37]

I talked to the eye MD this afternoon and gave her a complete family history (no history of glaucoma in either maternal or paternal great-grandparents, grandparents, aunts or uncles and no knowledge that anyone's optic nerve has the same abnormality).  I also asked her about a diagnosis and she said that there is no diagnosis -- just an abnormality in the way our daughter's optic nerve is.  Her recommendation is to continue routine eye exams with glaucoma tests at each unless there is any sort of concern with her vision, then she would want to see her.

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

Okay, some of the things that might cause that: optic nerve pit, optic nerve coloboma, optic nerve oblique insertion.

JH IIIMD

[MominNC37]

In the pictures the eye MD took of our daughter's optic nerves, she did not see a pit or evidence of a coloboma.  I don't know if she would have been able to tell if there is an oblique insertion.  Are there symptoms, other than vision problems, of course (eg., headaches) that we should watch for?  Are there things we can do proactively to strengthen her eye health or as preventative measures?  Thanks.

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

An oblique optic nerve insertion is easy to see with exam and pictures. See your Eye MD as directed. No exercise will help.

JCH III MD