[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Optic disc [Sense organs](https://durgical.com/en/anatomy/system/sense-organs/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Optic disc The optic disc is the pale round spot at the back of the eye where the optic nerve leaves; it has no light receptors, so it forms the blind spot. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=optic_disc&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The pale round spot where the optic nerve leaves the eye. ## What it does Has no light receptors (the blind spot); doctors look at it for glaucoma and brain swelling. ## Key points - Papilloedema is disc swelling, usually on both sides, from raised intracranial pressure: blurred margins, raised disc, hidden vessels, haemorrhages; vision is spared early apart from an enlarged blind spot - In glaucoma the cup widens as the neuroretinal rim thins, especially at the upper and lower poles; a difference in cup size between the eyes is a warning sign - The blind spot lies temporal to fixation in the visual field because the disc lies nasal to the fovea - Optic neuritis may show a swollen disc (papillitis) or a normal one (retrobulbar): the patient sees nothing and the doctor sees nothing ## Key facts **Where** Nasal to the macula; ~1.5–1.8 mm **Blood supply** Central retinal artery emerges here; short posterior ciliary arteries **Function** Exit of the optic nerve; blind spot; cup-to-disc ratio checked in glaucoma ## Relations **Contents** Axons of the retinal ganglion cells converging to form the [optic nerve](https://durgical.com/en/anatomy/optic-nerve/), with the [central retinal artery](https://durgical.com/en/anatomy/central-retinal-artery/) and vein entering and leaving near its centre **Behind** Lamina cribrosa, a sieve of [sclera](https://durgical.com/en/anatomy/sclera/) where the axons pass out and gain myelin, and then the optic nerve **Lateral** [Macula](https://durgical.com/en/anatomy/macula/), on the temporal side, linked to it by the papillomacular bundle **Medial** Nasal [retina](https://durgical.com/en/anatomy/retina/), whose nerve fibres run straight to the disc ## How to find it Found on fundoscopy by following any retinal vessel back to where the branches converge; with the patient looking ahead, the ophthalmoscope is aimed slightly nasally. A normal disc has a pink-orange rim, sharp margins and a pale central cup. ## Examination - Fundoscopy for colour, margins, cup and rim; spontaneous venous pulsations at the disc argue against raised pressure, though some healthy people lack them - Swinging flashlight test: a relative afferent pupillary defect points to optic nerve disease on that side - Visual fields: an enlarged blind spot in papilloedema, arcuate defects in glaucoma ## On imaging OCT measures the retinal nerve fibre layer and the rim; B-scan ultrasound or autofluorescence shows buried disc drusen; with a swollen disc, brain imaging comes before lumbar puncture to measure the opening pressure. ## Common problems - Glaucoma: the cup in the centre of the disc widens as nerve fibres are lost. - Papilloedema: the disc swells when pressure inside the skull is high (a warning sign). ## How it is diagnosed Looking at the disc with an ophthalmoscope, eye-pressure measurement, OCT of the nerve fibres and visual field tests. ## Treatment - Treat the cause: lower eye pressure in glaucoma; find and treat raised pressure in the skull. ## Clinical notes - Disc pallor (optic atrophy) follows long-standing damage of any cause: compression, ischaemia, glaucoma, inflammation - Anterior ischaemic optic neuropathy: sudden painless loss with a pale swollen disc; giant cell arteritis is the cause to rule out in older patients - Idiopathic intracranial hypertension, typically in young women with obesity, presents with papilloedema, headache and brief visual blackouts - Foster Kennedy syndrome: one atrophic and one swollen disc, classically from a frontal tumour ## Anatomical variants - Optic disc drusen: buried calcified deposits that mimic papilloedema (pseudopapilloedema) - Tilted, oval disc in myopia, with a crescent of exposed sclera or [choroid](https://durgical.com/en/anatomy/choroid/) at its edge - Myelinated nerve fibres: white feathery patches at the disc margin, harmless - Large physiological cup, usually the same in both eyes and often familial ## Development Ganglion cell axons grow back through the optic stalk; the hyaloid artery that ran through it regresses, leaving the central retinal artery, and a glial tuft on the disc (Bergmeister papilla) is a common remnant. ## Memory aid ISNT rule: the healthy rim is usually thickest Inferiorly, then Superiorly, Nasally and Temporally; breaking this order suggests glaucoma. ## Related conditions - [Open-angle glaucoma](https://durgical.com/en/conditions/open-angle-glaucoma/) - [Idiopathic intracranial hypertension](https://durgical.com/en/conditions/idiopathic-intracranial-hypertension/) - [Optic neuritis](https://durgical.com/en/conditions/optic-neuritis/) ## Test yourself Think of the answer, then tap the question to see it. ## What is papilloedema and what are its signs at the optic disc? Disc swelling from raised intracranial pressure, usually bilateral: blurred margins, raised disc, hidden vessels, haemorrhages; early vision is spared. ## How does the optic disc change in glaucoma? The cup widens as the neuroretinal rim thins, especially at the upper and lower poles; asymmetry between the eyes is a warning sign. ## Why is the blind spot temporal to fixation in the visual field? The optic disc, which has no photoreceptors, lies nasal to the fovea. ## What does the ISNT rule describe at the optic disc? The healthy rim is usually thickest Inferiorly, then Superiorly, Nasally and Temporally; breaking this order suggests glaucoma. ## In an older patient with sudden painless loss of vision and a pale swollen disc, which cause must be ruled out? Giant cell arteritis, as a cause of anterior ischaemic optic neuropathy. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/optic-disc/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** discus nervi optici TA2 6788 **Official Spanish (DeCS)** Disco Óptico DeCS D009898 **English (TA2)** Optic disc **Also called** optic nerve head · blind spot · papilla nervi optici ## Related - [Retina](https://durgical.com/en/anatomy/retina/) - [Optic nerve](https://durgical.com/en/anatomy/optic-nerve/) - [Central retinal artery](https://durgical.com/en/anatomy/central-retinal-artery/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=10078); [Papilledema](https://www.ncbi.nlm.nih.gov/books/NBK538295/); [Anatomy, Head and Neck: Retina](https://www.ncbi.nlm.nih.gov/books/NBK542332/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/optic-disc/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/optic-disc/