Optic Disc Drusen

What are optic disc drusen?

Optic disc drusen refer to deposits in the optic disc in the back of your eyes. Fatty proteins and calcium make up these deposits, or drusen.

The word “drusen” comes from a German word for geodes or rocks. Drusen of the optic disc can harden as you age.

The optic disc, also called the optic nerve head, is the front part of your optic nerve.

Optic disc drusen can happen in only one eye (unilateral) but are more common (about 75%) in both eyes (bilateral). They can sometimes cause loss of vision.

How common are optic disc drusen?

Optic nerve drusen happen in about 1% to 2% of the U.S. population, according to one estimate. They affect everyone equally, regardless of sex. Another estimate puts the rate at 1.8% to 2.4%. White people tend to develop optic disc drusen more often than people of other races.

What are the signs and symptoms of optic disc drusen?

Many times, there are no symptoms of optic disc drusen. Sometimes, eye care specialists may find the drusen during a regular eye exam. About 87% of people with optic disc drusen have visual field defects, which can include a large blind spot. The visual field is everything we can see: central vision (what’s right in front of us) and peripheral vision (everything surrounding central vision). Other possible symptoms include:

• Having gray or blurry vision for short time periods.
• Losing peripheral vision.
• Having white or yellow lumps on your optic discs that an ophthalmologist or other provider can see during an examination. “Buried” optic disc drusen are ones a provider can’t see easily, as opposed to “visible” optic disc drusen.

What causes optic disc drusen?

Fatty proteins and other substances form the deposits in optic disc drusen, but scientists don’t know exactly why these substances collect and harden. Some cases are inherited.

How are optic disc drusen diagnosed?

Your provider may find the drusen during a routine exam. They may follow up with other tests, including:

• Visual field testing.
• Optical coherence tomography.
• Ultrasound.
• CT (computed tomography) scan.
• Fluorescein angiography, which uses a special camera and fluorescent dye to show the back of your eye.
• Fundus autofluorescence, a noninvasive imaging technique that uses your body’s own lipofuscin (a pigment that accumulates as you age, or results from some conditions, and is stored in certain cells). Your provider doesn’t need to inject dye because lipofuscin has fluorescent properties.

How do healthcare providers treat optic disc drusen?

If you have optic disc drusen, you’re not likely to need treatment or management. Currently, there’s no surgery or cure for optic disc drusen.

How can I prevent optic disc drusen?

There’s no way to prevent optic disc drusen.

What can I expect if I have optic disc drusen?

The outlook (prognosis) for someone with optic disc drusen is generally very good, though many patients can lose some peripheral vision.

In rare cases, you may have a complication related to optic disc drusen. Rare complications may include developing:

• Choroidal neovascular membranes that can bleed and cause central vision loss. If this happens, you may need to have laser treatment to stop the bleeding.
• Anterior ischemic optic neuropathy.
• Retinal vascular occlusions.

Are optic disc drusen serious?

While you may have some vision loss, optic disc drusen aren’t usually dangerous. But they can be associated with other types of disorders.

When should I see my healthcare provider?

It’s important to see your healthcare provider for regular vision testing. You should consult a provider whenever you have any changes in your vision.

What is the difference: papilledema vs. optic disc drusen?

Some people call drusen of the optic nerve head by the name “pseudopapilledema.” Papilledema describes swelling of the optic disc due to high pressure within your skull (intracranial pressure). It’s a medical emergency.

“Pseudo” refers to something that’s fake. Optic disc drusen may cause your optic nerve head to look swollen, even when it really isn’t.

Optic disc drusen vs. glaucoma

Optic disc drusen and glaucoma both cause problems with your visual field. They can also happen at the same time. Your provider must be able to diagnose you accurately to ensure correct treatment. Glaucoma is dangerous to your eyesight and requires treatment.

Optic disc drusen vs. retinitis pigmentosa

People with retinitis pigmentosa (RP) have higher rates of optic disc drusen overall, but people with certain types of RP have even higher rates, including preserved para-arteriole retinal pigment epithelium RP and Usher syndrome.

Optic disc drusen and Noonan syndrome

Noonan syndrome is a genetic disorder that can include issues with optic disc development. You may have optic disc drusen if you have Noonan syndrome.

A note from Cleveland Clinic

Optic disc drusen, or rocklike formations in your optic discs, may cause no problems. You might not even know you have it until you have an eye exam. You’re not likely to need treatment unless it’s associated with other conditions. As always, it’s important to keep track of any type of vision change and to speak to a provider about these changes in signs and symptoms.