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Eye and Vision Care

Optical Nerve Fluid Distention

09/15/2010

Question:

My wife had an MRI and the DR told her she had Optical Nerve fluid distention. I can not find any thing on this what is it?

Answer:

I am suspecting that reduced visual acuity or headaches may have prompted the MRI to be performed. Optic nerve fluid distension can occur with inflammation to the optic nerve occurs (optic neuritis) or with papilledema.

Distension of the nerve with optic neuritis is not common but can occur. (Here is an online case report): British Journal of Ophthalmology 2003;87(2):249 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1771494/

When inflammation occurs, excess fluid is typically present which causes swelling, or in this case fluid distension. When the optic nerve becomes inflamed, the surrounding fluid fills in a potential space between the nerve itself and its surrounding meninges. The meninges are a protective covering that covers the brain and the optic nerve. For the optic nerve, think of the meninges as the rubberized coating over an electronic cable. The metal part of the cable is "the optic nerve" and the coating is the meninges. In the body, these coatings can become flexible and therefore retain fluid.

Papilledema occurs when there the cerebrospinal fluid pressure (CSF) in the brain goes up. This can be due to a blockage of the drainage mechanism. Since the optic nerves are bathed in CSF, if the pressure goes up, swelling can occur to the optic nerves.

Either condition is serious, although manageable in most cases. With the proper treatment, the optic nerve distension should subside and hopefully your wife's vision will return to a point near what it was prior to the onset of this condition.

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Response by:

Aaron  Zimmerman, OD, MS Aaron Zimmerman, OD, MS
Clinical Associate Professor of Optometry
College of Optometry
The Ohio State University