Abstract

Purpose: To analyze the etiological spectrum of pale optic discs and assess their correlation with visual outcomes in patients presenting to a tertiary care hospital. Methods: A prospective observational study was carried out on 40 patients above 20 years of age with optic disc pallor. Detailed history, clinical examination, and investigations including fundus photography, perimetry, biochemical tests, and neuroimaging were performed. Best Corrected Visual Acuity (BCVA) was recorded at baseline and at six months follow-up. Data were analyzed for etiological patterns and correlation with visual prognosis. Results: The mean age of participants was 38.68 ± 12.09 years, with male predominance (56%). The most common etiology was traumatic optic neuropathy (28%), followed by optic neuritis (22%) and intracranial tumors (22%). Primary optic atrophy accounted for 16% of cases, while toxic, ischemic, and inflammatory causes contributed less frequently. At six months, only 34% of patients showed improvement in BCVA, predominantly in optic neuritis and traumatic cases. Tumor-related cases showed partial recovery, while ischemic and primary atrophy cases had poor outcomes. Conclusion: Optic disc pallor is a clinical sign of diverse etiologies with variable prognosis. While overall visual recovery was limited, early recognition of inflammatory and compressive causes provided better outcomes. Timely evaluation and targeted management are crucial in preserving residual vision.

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