This 33YO male has no light perception vision bilaterally following a failed shunt for hydrocephalus when he was 13YO. Both optic nerves are severely pale.
There are also bilateral macular pigmentary changes, most likely from resolved secondary macular edema when his nerves were severely swollen before his shunt.
Learning Points:
Secondary optic nerve atrophy and vision loss can occur in cases if increased intracranial pressure is not controlled.
