WSJ.com - Health Journal

Optic Nerve Hypoplasia on the rise vs increased detection?!

WSJ.com - Health Journal:
"During Jack Steinberg's six-month checkup last year, his pediatrician detected something amiss in the baby's gaze. Her recommendation that Jack see a pediatric ophthalmologist didn't much worry the baby's parents, who thought a prescription for eyeglasses would be the worst outcome.

It wasn't. Jack turned out to be a victim of a condition whose rising prevalence mystifies opthalmologists. Called optic nerve hypoplasia, the condition, which can cause total blindness, was discovered during the late 19th century but was thought to strike extraordinarily rarely. 'I've searched the literature and found only 36 cases in the Western world' before the 1970s, says Mark Borchert, a University of Southern California pediatric neuro-ophthalmologist.

'It used to be so rare that people would trade slides of the few known cases,' says Michael Brodsky, a pediatric neuro-ophthalmologist at University of Arkansas for Medical Sciences in Little Rock. Since the 1970s, however, diagnoses of optic nerve hypoplasia have escalated. Dr. Borchert says he alone has seen at least 500 victims, and he estimates there are thousands of cases nationwide. Hard numbers on children who are blind or visually impaired are difficult to obtain. But, says Dr. Brodsky, 'these cases are now filling up our clinics.'

Is the explanation better diagnosis or more cases? 'That's the big unknown,' says Creig Hoyt, chairman of the opthalmology department at the University of California at San Francisco."