Visual field loss and a relative afferent pupillary defect in a patient with optic nerve head drusen

Optic nerve head drusen often cause several diopters of disc elevation and are important etiology of pseudopapilledema. Compression of nerve fibers between the lamina cribrosa and prelaminar drusen may cause corresponding visual field defects. Significantly asymmetric visual field loss may be associated with a relative afferent pupillary defect. Central visual field loss from optic nerve drusen is a rare phenomenon that requires an extensive ophthalmic work-up to rule out other pathology.