What to Know About Optic Nerve Drusen

Medically Reviewed by Mahammad Juber, MD on August 30, 2022
5 min read

Optic nerve drusen is an eye problem that could occur at any age. It can cause some mild visual issues but is usually symptomless. Most of the time, you won’t even know that you have this condition until you’re told by your eye doctor. 

Optic nerve drusen is also called optic disc drusen. 

Optic nerve drusen is a rare eye condition that affects between 3 and 24 people out of every 1,000 in the population. It’s difficult to estimate exactly how common this condition is, though, because many people don’t know that they have it.

Optic nerve drusen is bilateral in more than 70% of cases. This means that it affects both of your eyes. However, the condition can be more severe in one eye than it is in the other. In other cases, only one eye is affected. 

This condition specifically affects your optic nerve. This is a necessary part of your eye. Its main job is to transmit visual information from your eye to your brain. It serves as a physical connection between these two organs. 

In cases of optic nerve drusen, your optic nerve becomes lumpier. This may affect parts of your vision. Overall, though, this is considered a mild eye problem and isn’t an overwhelming cause for concern. 

Anyone can get optic nerve drusen at any age. Even children can be diagnosed, though it rarely affects anyone under the age of four. 

Males are just as likely to develop this condition as females. For unknown reasons, though, this problem is more common for Caucasian people than for people of other races. 

No one knows the exact cause of optic nerve drusen. You can inherit this condition from close family members, but you could also be the first in your family to develop this condition. Researchers are still trying to understand the heritable component

The drusen is caused by proteins and other bits of debris that become calcified and gather on your optic nerve. This causes a characteristic bumpy appearance. The calcified bits build up over time, and this can cause mild problems with your vision.  

The most common way that optic nerve drusen is diagnosed is during a routine eye exam. Your eye doctor can sometimes see the bumpy appearance of your optic nerve when they dilate your eye. 

Visual tests can help them definitively diagnose the problem. However, some cases of optic nerve drusen are on the surface of your nerve, and others are buried. The buried ones are more difficult to see.  

The most important part of the diagnostic process is distinguishing between cases of optic nerve drusen and actual swelling of your optic nerve, called edema.  Edema could indicate a much more serious condition that involves swelling within your brain

Imaging techniques can help your eye doctor distinguish between these two conditions. One study found that optical coherence tomography (OCT) with enhanced depth imaging was the most effective technique for detecting buried drusen. It was able to detect the condition 100% of the time, a much higher success rate than ultrasound. 

OCT takes pictures of your eye to construct a three-dimensional model and ultrasound depends on sound waves to help visualize your inner eye structures. 

You likely won’t notice any symptoms from your optic nerve drusen. However, symptoms may get worse as the calcified substances accumulate throughout your lifetime.

The most common symptom is a mild loss of peripheral vision. This is the type of vision that you use at the edges of your field of view. Many people don’t initially notice this deterioration. Your eye doctor, though, can check your total visual field with a special test to see if you’re blind in any areas. 

The area where you’ve lost peripheral vision may grow over time but usually never becomes bad enough to interfere with day-to-day activities. Up to 25% of people with optic nerve drusen eventually experience defects, like blind spots, in their peripheral vision. 

Another 10% of people with this condition report transient visual problems. These are inconveniences that don’t affect large portions of your vision and aren’t permanent. 

The most dangerous consequence of optic nerve drusen is that it puts you more at risk of a dangerous condition called choroidal neovascularization. This occurs when new blood cells form close to your optic nerve. 

Sometimes, these blood cells don’t move normally. Instead, they frequently start to leak into the eye. If untreated, the leaking blood can affect your central vision. This can quickly cause severe forms of blindness.  

At present, there’s no accepted treatment for optic nerve drusen. Physicians have tried a handful of treatments in the past, but they don’t seem to be very effective or worthwhile. In fact, surgeries to remove the drusen could be worse for your eyes than just doing nothing. 

You’ll need some form of treatment, though, if you develop choroidal neovascularization. In this case, your eye doctor may recommend laser treatment to fuse the irregular blood vessels and stop the bleeding. 

Alternatively, your doctor could recommend newer injectable medications to treat the leakage. These medications are injected directly into your eye. 

People with optic nerve drusen usually have good overall vision despite some minor issues. However, it’s still important to get regular eye exams. That way, your eye doctor can see how your condition is progressing. They can also detect any secondary complications as soon as they start. This could be crucial for saving your vision in the long run. 

Always see your eye doctor as soon as possible if you notice any new symptoms or believe that your peripheral vision loss is getting worse. 

You should also talk to close family members once you’ve been diagnosed with optic nerve drusen. Since this condition is sometimes heritable, there’s a chance that they have it too. Your close blood relatives should tell their eye doctors about your diagnosis and have their eyes checked during their next examination.