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Nutritional and Toxic Optic Neuropathies


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Nutritional and toxic optic neuropathies are medical disorders in which a person has suffered vision loss due to optic nerve (nerve that connects the brain to the eyes) damage. Nutritional optic neuropathy can be caused by lifestyle choices – such as alcohol abuse or smoking – or due to nutritional deficiencies (lack of B1 or B12 vitamins), from either poor intake or malabsorption (body does not properly absorb the vitamins).

Toxic optic neuropathies can occur due to bad reactions to some medications, such as:

  • Amiordaone: used for abnormal heart rhythm and can cause sudden vision loss
  • Ethambutol: used for lung infections and can cause vision loss over time
  • Tacrolimus: used for immunosuppression and can cause vision loss over time


Comprehensive exam - Your doctor will conduct a thorough physical examination of your eyes – as well as gather a complete health history – to determine if you have a pupillary abnormality. This may include using eye drops to dilate your pupils to see how each react to the dilation process.

Blood tests - Your doctor may order a blood test to check for nutritional deficiencies.

Visual field - A visual field test assesses both central and peripheral vision.

Optical coherence tomography - The test measures the thickness of the cell layers and nerve fibers that make up the optic nerves to assess optic nerve damage.

Optic nerve photos - The test documents the amount of optic nerve swelling.


Nutritional supplementation - If you have nutritional optic neuropathy, your doctor may order intramuscular and/or oral supplements to correct supplemental deficiencies.

Discontinue medication - If you have toxic optic neuropathy related to adverse reaction to a medication, the medication needs to discontinued immediately and be replaced appropriately by a doctor.

Discontinue alcohol and smoking - If you have nutritional optic neuropathy related to excessive alcohol use, you should immediately discontinue alcohol use, as well as smoking.

Why Choose Bascom Palmer Eye Institute?

Ranked #1 by U.S. News & World Report. Bascom Palmer Eye Institute, part of the University of Miami Health System, is the top-ranked facility in the country for the treatment of diseases and disorders of the eye. When you choose us for your eye care, you will receive the best care in the nation in a compassionate setting.

Support for you and your family. A challenging medical condition requires patience and support from your health care team. You will find both at Bascom Palmer. Our eye care teams connect you to the services and support you need, with kindness and compassion. 

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