Survey of Ophthalmology
Volume 55, Issue 5 , Pages 403-428, September 2010

Tilted Optic Disks

  • Matthew T. Witmer, MD

      Affiliations

    • Department of Ophthalmology, University of South Florida, College of Medicine, Tampa, Florida, USA
    • Corresponding Author InformationReprint address: Dr. Matthew T. Witmer, 12901 Bruce B. Downs Blvd., USF Eye Institute, MDC 21,Tampa, FL 33612.
    • ,
  • Curtis E. Margo, MD, MPH

      Affiliations

    • Department of Ophthalmology, University of South Florida, College of Medicine, Tampa, Florida, USA
    • Department of Pathology, University of South Florida, College of Medicine, Tampa, Florida, USA
    • ,
  • Mitchell Drucker, MD

      Affiliations

    • Department of Ophthalmology, University of South Florida, College of Medicine, Tampa, Florida, USA

published online 12 July 2010.

Abstract 

Tilted optic disks are a common finding in the general population. An expression of anomalous human development, the tilted disk appears rotated and tilted along its axes. Visual sequelae described with tilted optic disks include myopia, astigmatism, visual field loss, deficient color vision, and retinal abnormalities. Although the natural course of tilted optic disks is nonprogressive, the anomaly can be mistaken for tumors of the anterior visual pathway, edema of the optic nerve head, or glaucoma. A thorough examination of patients with tilted disk includes refraction, dilated fundus examination, and visual field testing. At times, neuroimaging may be necessary to arrive at the correct diagnosis. Until normative data are validated for tilted disks, the role of new imaging technologies for the optic nerve head is limited. Familiarity with the spectrum of ophthalmoscopic appearance and the clinical manifestations of tilted disks may be the most critical factors in avoiding misdiagnosis.

Key words: astigmatism, myopia, optic disk, optic nerve, optic nerve head, tilted disk, visual field loss

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 The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(10)00039-1

doi:10.1016/j.survophthal.2010.01.002

Survey of Ophthalmology
Volume 55, Issue 5 , Pages 403-428, September 2010

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