The pale nerve

摘要

Dr Lee: Consider a healthy 55 year old man found by the optometrist to have a visual field defect and pale optic nerves, 20/25, no afferent defect, slit lamp was normal and intraocular pressures of 18 (Fig. 1). Which of these nerves in this patient would lead you to (a) image; (b) not image; or, phrased another way, how do you judge rim pallor in the setting of optic nerve cupping?