Do we really understand the difference between optic nerve hypoplasia and atrophy?

(Conclusion) Optic nerve hypoplasia is now recognized as a frequent clinical disorder. The profile of this optic nerve anomaly has radically changed in the last 20 years and its diverse and subtle forms are increasingly appreciated by ophthalmologists. The simplistic notion that it results from a failure of ganglion cell development no longer seems to be tenable. It is enticing to endorse the notion that it represents an exaggeration of the normal process of axonal cell death that occurs in the developing visual pathways. However, this thesis has its problems. Further investigation of the development of the normal optic nerve is necessary before we can unravel some of the puzzles that surround the pathophysiology of optic nerve hypoplasia and optic atrophy.