I have a large number of patients with optic nerve drusen. Now I see them once a year. Since there is no treatment, I don't know if this is the right attitude.
Dear Dr Martin-Moro
My management of these patients includes two steps: 1. I send a letter to the general ophthalmologist and the GP in order to inform them about nature and signs of the disease. I normally send a copy of the letter to the patient and ask him to include this to his personal medical files (which should be taken to any first time consultations of medical professionals). These measure should be taken to avoid unnecessary expensive and sometimes invasive diagnostic procedures (NMR, CT, lumbar punction etc). 2. I look very carefully for the development of ocular hypertension and/or glaucome. Optic discs with drusen tend to be very sensitive to increased ocular pressure. Therefore I indicate antiglaucomateous treatment in these eyes earlier than in average patients. The latter aspect is a good argument in favour of continuing with regular observations in these patients.
Kind regards,
Heinrich
Dear Heinrich:
Thanks very much for your advice.
In that case an annual visit can be worthy.
Best regards.
Julio.
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