Name of the Condition

• Late Congenital Syphilitic Optic Nerve Atrophy
• Also known as Optic Atrophy due to Late Congenital Syphilis.

Summary

Late congenital syphilitic optic nerve atrophy is a rare condition where the optic nerve, responsible for transmitting visual information from the eye to the brain, undergoes degeneration as a result of untreated syphilis contracted congenitally (from birth). This leads to vision problems or potentially blindness if not addressed.

Causes

• Caused by a congenital syphilis infection, which occurs when the Treponema pallidum bacterium is transmitted from an infected mother to her child during pregnancy.

Risk Factors

• Being born to a mother with untreated syphilis at the time of pregnancy.
• Lack of prenatal care and syphilis screening during pregnancy.

Symptoms

• Decreased visual acuity or loss of vision.
• Pale appearance of the optic disc when examined by an eye specialist.
• Possible development of other late-stage syphilitic symptoms if the infection is not treated.

Diagnosis

• Comprehensive eye examination including visual acuity and fundoscopic examination.
• Blood tests to detect the presence of syphilis antibodies in both child and mother.
• Lumbar puncture to examine cerebrospinal fluid for evidence of syphilis may be recommended.

Treatment Options

• Antibiotic treatment often involving penicillin to treat the underlying syphilis infection.
• Vision rehabilitation strategies to cope with any degree of vision loss.
• Regular follow-ups with an ophthalmologist to monitor changes in vision.

Prognosis and Follow-Up

• If detected early, treating the syphilitic infection can prevent further vision damage, but existing damage may be irreversible.
• Regular check-ups with both infectious disease specialists and ophthalmologists are crucial to manage and monitor the condition.

Complications

• Permanent vision impairment or blindness if untreated.
• Potential for neurological complications if syphilis spreads to other nervous system regions.

Lifestyle & Prevention

• Ensuring pregnant women have access to comprehensive prenatal care including routine screenings for syphilis prevents congenital infections.
• Protective sexual practices and regular health check-ups for sexually active individuals to prevent syphilis infections in the mother.

When to Seek Professional Help

• Immediate medical attention is necessary if any sudden loss of vision occurs or if a child born to a mother with syphilis exhibits signs of vision problems.

Additional Resources

• American Academy of Ophthalmology (AAO)
• Centers for Disease Control and Prevention (CDC)
• Syphilis support groups and patient advocacy organizations.

Tips for Medical Coders

• Ensure to verify if the optic nerve atrophy is a result of syphilis for accurate coding as A50.44.
• Be thorough in reviewing medical records for syphilis history to avoid miscoding other causes of optic atrophy.