Optic Nerve Drusen

AI was a 10-year-old boy who complained of headaches severe enough to keep him home from school on several occasions for several months. He was taken to his pediatrician and then referred to a comprehensive ophthalmologist, who felt the optic discs were elevated. He was then referred to a neurologist who hospitalized the child and did a complete neurological examination, ordered a CT scan and then an MRI scan and subsequently a cerebral angiogram, and performed a lumbar puncture. This US $20,000 workup proved to be negative for central nervous system pathology. He ultimately was referred for echography, where B-scan quickly demonstrated buried calcified drusen as the cause for the disc irregularity (Fig. 1). A-scan measured the diameter of the optic nerves in the orbit to be within normal limits.