Vision Issues: Thin Optic Nerve and Shadow Symptoms - Ophthalmology

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Hello, thank you for your question. Based on your description, it seems you are experiencing some concerning visual symptoms related to your optic nerve health. The thinning of the optic nerve, particularly in the upper part, combined with the presence of shadows or black spots in your vision, could indicate a few potential issues that warrant further investigation.

Firstly, the optic nerve is crucial for transmitting visual information from the retina to the brain. When there is thinning of the optic nerve, it can be a sign of optic nerve damage or a condition known as optic neuropathy. This can occur due to various reasons, including glaucoma, ischemic optic neuropathy, or other neurological conditions. The fact that your doctor noted a thickness of 79 micrometers in the upper part of your optic nerve, compared to a normal thickness of 100 micrometers, is indeed a point of concern.

The black shadow you are experiencing, particularly when you exert effort to open your eyes wide, could be related to several factors. One possibility is that this shadow is a result of the visual field loss associated with optic nerve damage. When the optic nerve is compromised, it can lead to scotomas, which are areas of partial or complete loss of vision surrounded by a field of normal vision. The fact that the shadow seems to move with your facial changes may suggest that it is related to your visual field rather than an issue with the eye itself.

It is also important to consider that the symptoms you describe could be influenced by the underlying condition that led to the thinning of your optic nerve. For instance, if you have been diagnosed with glaucoma, the increased intraocular pressure can lead to further damage to the optic nerve, resulting in visual field defects. Similarly, if there is any inflammation or swelling affecting the optic nerve, it could manifest as changes in your visual perception.

Given the complexity of your symptoms and the potential implications for your vision, I strongly recommend that you follow up with your ophthalmologist or a neuro-ophthalmologist. They may suggest further tests, such as optical coherence tomography (OCT), visual field testing, or even imaging studies like an MRI to assess the health of your optic nerve and rule out any serious underlying conditions.

In summary, the thinning of your optic nerve and the presence of shadows in your vision are concerning signs that should not be ignored. It is crucial to have a thorough evaluation to determine the cause of these symptoms and to establish an appropriate management plan. Early intervention can be key in preserving your vision and preventing further damage. Please make sure to communicate all your symptoms clearly to your healthcare provider, and do not hesitate to seek a second opinion if you feel it is necessary. Your vision is important, and taking proactive steps is essential for your eye health.