Optic nerve drusen and pseudopapilledema

Area of Science:

• Ophthalmology
• Neurology

Background:

• Optic nerve head drusen are calcified deposits within the optic nerve head.
• While typically associated with visual field defects, they rarely cause decreased visual acuity.

Observation:

• A patient presented with unilateral visible optic nerve head drusen and contralateral visual acuity loss.
• The patient also had moderate hypermetropia and used oral contraceptives.
• Recent onset headache accompanied the unilateral visual acuity loss.

Findings:

• Extensive investigations ruled out other causes for the visual acuity loss.
• The presentation raised suspicion for misdiagnosis of papilledema or papillitis.
• A tentative diagnosis of buried optic nerve drusen was considered for the affected eye.

Implications:

• This case highlights a rare presentation of optic nerve head drusen.
• It emphasizes the importance of considering optic nerve drusen in cases of unexplained visual acuity loss.
• The potential role of hypermetropia and oral contraceptives warrants further investigation.