Incidental bilateral optic nerve hypoplasia

Description

A 19-year-old man was incidentally noted to have a bitemporal heteronymous hemianopia on automated perimetry during his first optician's sight test (figure 1). The patient reported life-long reduced vision in the right eye although this was his first presentation to ophthalmic services. The patient was induced at 34 weeks due to poorly controlled gestational diabetes in his mother. The patient had no other ocular, medical, drug or family history.

Figure 1

24-2 Humphrey Visual Field Test demonstrating a bitemporal heteronymous hemianopia.

On examination, visual acuity was 6/9 in the right eye and 6/6 in the left eye. The anterior segment was normal. Funduscopy demonstrated bilateral hypoplastic optic discs with the characteristic 'double-ring sign' (figure 2). The disc diameter to disc–macula distance ratios were 0.33 and 0.31 in the right and left eyes, respectively (figure 3)....

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