Absence of VEP - Pediatric Oncall

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Question
My daughter has difficulty in vision. She is 3years old. We visited an opthemologist for her checkup and his report is : VEP was absent in both eyes. ERG was normal. MRI Scan of brain was normal. Her extraocular movements were full. Anterior segment examination was within normal limits. Fundus examination showed optic atrophy in both eyes with attenuated arterioles in both eyes. What is her problem? Whether she could see or not ? Is the problem accute ? Whether it is curable? If yes, how? Please give advice and name out the medicines.
Answer
An absent VEP suggest problem in the pathway connecting the eye to the brain which as the fundus examination suggests is atrophy of the optic nerve. The visual center in the brain and the front portion of the eye are normal but the optic nerve (the nerve that carries the visual sensation to the brain) is affected. The cause of optic atrophy could be varied, the commonest being intracranial infections. It could also be due to increased pressure in the brain or even due to some neurological insult. The condition is usually irreversible and not curable. You will have to consult your ophthalmologist as to what is the vision that your child would be able to achieve. Complete recovery is not possible. Back to All Questions

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