Tilted disc syndrome

Background. Tilted disc syndrome (TDS) has a varied morphological appearanc e which can be difficult to differentiate from acquired optic nerve patholo gy. In addition, there are visual deficits and potential complications asso ciated with this syndrome. Failure to recognize features of the TDS frequen tly leads to unnecessary medical evaluation or improper examination for pos sible associated ocular complications. Methods. The literature is reviewed to examine the embryonic developmental defects that create TDS. Characteris tic ophthalmoscopic features of the disc, visual field deficits, electrofun ctional abnormalities, retinal pigment epithelial and choroidal hypoplasia, refractive error, and choroidal neovascular development are examined from a clinical standpoint. Results. The literature clearly identifies visual de ficits and ocular complications, which must be understood in the context of TDS. Conclusions. TDS is a congenital anomaly that has visual deficits and an appearance that can mimic serious neurological disease. Also, there are potential vision-threatening complications that are typically not associat ed with a congenital anomaly.