A case of amblyopia with contralateral optic nerve hypoplasia

Abstract

We describe an unusual case of unilateral optic nerve hypoplasia (ONH) in a patient with contralateral anisometropic/strabismic amblyopia. A seven‐year‐old boy presented with visual acuities of 6/12 R and 6/18-L and eccentric fixation in the left eye. Cycloplegic retinoscopy was R +1.50/‐0.50 × 180 and L +5.25 DS. Funduscopy revealed optic nerve hypoplasia of the right eye. The patient fixated with his better‐seeing right eye, despite the optic nerve hypoplasia. His reduced vision may be attributed to optic nerve hypoplasia in the right eye and amblyopia in the left. Although optic nerve hypoplasia can occur with ipsilateral amblyopia, we believe this is the first reported case of unilateral optic nerve hypoplasia in the fellow eye of an amblyopic patient.

Key words:

• amblyopia
• anisometropia
• optic nerve hypoplasia
• strabismus

Acknowledgements

This manuscript was presented in part at the Annual Meeting of the American Academy of Optometry, November 2009, in Orlando, Florida, USA.

We thank Dr Michael Chaglasian for assisting with optic nerve analysis and Danielle Nesbitt for translating reference 9 from the original French.