In the past, the importance of recognizing a hypoplastic optic nerve has been stressed in order to avoid fruitless occlusion therapy for amblyopia. Two cases of hypoplasia with good visual acuity are presented showing that striking hypoplasia and marked field loss may be present with sparing of central acuity. The reviewed literature shows a large range of visual function in optic nerve hypoplasia with a relationship between central vision and pupillary response. Since one cannot reliably predict whether or not central vision is affected from the appearance of the disc, a trial of occlusion therapy is indicated for a child with hypoplastic optic nerve and squint.
Gardner HB, Irvine AR. Optic Nerve Hypoplasia With Good Visual Acuity. Arch Ophthalmol. 1972;88(3):255-258. doi:10.1001/archopht.1972.01000030257005