{"schema":"https://ver.cy/schemas/card/1.0.0","id":"vr.tr.optic-nerve-disease","code":"thing-q2879095","url":"https://ver.cy/models/thing/q2879095/","name":"optic nerve disease","alternateNames":["optic nerve tumor","anterior optic tract meningioma","ischemic optic neuropathy","optic nerve injury","hereditary optic neuropathy","optic disk drusen"],"kind":"thing","status":"published","version":"0.1.0-research.1","language":"en","classifiers":{"family":"Thing Registry","category":"Cross-cutting context","entryKind":"thing","plane":"XCT","domain":["XCT.STA"],"industry":[],"navPath":"","tags":[],"facets":{}},"whatItIs":"Optic nerve disease is a group of disorders that damage or impair the axons of retinal ganglion cells forming the optic nerve, potentially causing loss of vision, visual field defects, and impaired colour perception.","purpose":"Enable an agent to recognise optic nerve disease as a class of conditions, record evidence of optic nerve injury and visual dysfunction, and support decisions appropriate to the suspected cause and diagnostic certainty.","scope":{"in":["Localisation of disease to the optic nerve, including the optic disc and the nerve up to its junction with the optic chiasm","Aetiological classification and relationships to systemic, ocular, hereditary, exposure-related, and intracranial causes","Eye-specific visual dysfunction and structural evidence of optic nerve injury","Onset, activity, progression, recurrence, and residual impairment","Diagnostic evidence, uncertainty, classification versions, and management implications"],"out":["Retinal or macular disease without optic nerve involvement","Isolated chiasmal, optic tract, optic radiation, or visual cortical disease","Patient identity and the complete longitudinal health record","Clinical visits, referrals, investigations, and procedures as care events","Underlying systemic diseases, intracranial lesions, and exposure sources as independently modelled entities"],"boundaries":[]},"distinguishingFeatures":["Require evidence supporting optic nerve localisation; reduced visual acuity alone does not establish optic nerve disease.","Assess whether visual-field, colour-vision, pupillary, disc, and imaging findings form a coherent optic nerve pattern rather than a retinal or posterior visual pathway explanation.","Distinguish an observed swollen or pale optic disc from an established disease mechanism; record the sign and its interpretation separately.","Separate glaucomatous and non-glaucomatous optic nerve injury using documented evidence rather than intraocular pressure alone.","Distinguish suspected active injury from persistent structural loss or visual impairment after an earlier episode."],"structure":{"bundles":[{"id":"optic-nerve-localisation","name":"Optic nerve localisation","description":"Establishes what is affected and whether optic nerve disease is the appropriate concept.","layers":[{"id":"anatomical-boundary","name":"Anatomical boundary","description":"Places the suspected lesion within the visual pathway.","findings":[{"id":"eye-and-nerve-segment","name":"Eye and nerve segment","description":"Record laterality, suspected optic nerve segment, and evidence for any extension beyond the nerve.","questions":[{"text":"Which eye and optic nerve segment are implicated, and what examination or imaging evidence supports that localisation?","id":"eye-and-nerve-segment-q01","kind":"measurement"},{"text":"Does the process also involve the retina, chiasm, or posterior visual pathway, requiring links to additional condition models?","id":"eye-and-nerve-segment-q02","kind":"boundary"}]}]},{"id":"localisation-evidence","name":"Localisation evidence","description":"Tests the coherence of functional and anatomical observations.","findings":[{"id":"optic-neuropathy-evidence","name":"Evidence for optic neuropathy","description":"Keep the localisation judgment separate from individual signs and alternative explanations.","questions":[{"text":"How do visual fields, colour vision, pupillary responses, and structural findings support or challenge optic nerve dysfunction?","id":"optic-neuropathy-evidence-q01","kind":"definition"},{"text":"Which retinal, media-related, or posterior pathway explanations remain plausible, and what evidence distinguishes them?","id":"optic-neuropathy-evidence-q02","kind":"boundary"}]}]}]},{"id":"cause-and-diagnostic-identity","name":"Cause and diagnostic identity","description":"Represents aetiological hypotheses and the diagnosis supported by available evidence.","layers":[{"id":"causal-differentiation","name":"Causal differentiation","description":"Organises competing and potentially coexisting mechanisms.","findings":[{"id":"aetiological-hypotheses","name":"Aetiological hypotheses","description":"Record candidate causes, supporting and conflicting evidence, and causal uncertainty.","questions":[{"text":"Which glaucomatous, inflammatory, ischaemic, compressive, hereditary, toxic, nutritional, infectious, infiltrative, or traumatic mechanisms are supported?","id":"aetiological-hypotheses-q01","kind":"definition"},{"text":"Which history, imaging, laboratory, exposure, or genetic observations support each hypothesis, and where were they obtained?","id":"aetiological-hypotheses-q02","kind":"provenance"}]}]},{"id":"criteria-and-coding","name":"Criteria and coding","description":"Connects diagnostic assertions to their clinical and terminology authorities.","findings":[{"id":"versioned-diagnostic-assertion","name":"Versioned diagnostic assertion","description":"Preserve the source, certainty, and specificity of the diagnosis independently of billing or classification labels.","questions":[{"text":"What diagnostic criteria or specialist judgment supports the named subtype, and what issuing body and version apply?","id":"versioned-diagnostic-assertion-q01","kind":"provenance"},{"text":"Which ICD or SNOMED CT concept matches the supported scope, and what release, jurisdiction, and mapping limitations accompany it?","id":"versioned-diagnostic-assertion-q02","kind":"boundary"}]}]}]},{"id":"visual-function-and-structure","name":"Visual function and structure","description":"Captures the measurable effects of disease on vision and optic nerve anatomy.","layers":[{"id":"functional-profile","name":"Functional profile","description":"Records multiple dimensions of eye-specific visual function.","findings":[{"id":"visual-performance","name":"Visual performance","description":"Describe acuity, field, colour, and other assessed visual functions using explicit methods.","questions":[{"text":"What are the per-eye acuity, visual-field, and colour-vision results, including correction, protocol, reliability, and date?","id":"visual-performance-q01","kind":"measurement"},{"text":"Which reported difficulties with reading, navigation, or contrast correspond to measured impairment, and which remain unexplained?","id":"visual-performance-q02","kind":"measurement"}]}]},{"id":"structural-profile","name":"Structural profile","description":"Records optic disc, retinal axonal, and optic nerve imaging observations.","findings":[{"id":"structural-evidence-and-limitations","name":"Structural evidence and limitations","description":"Separate observed structural abnormalities from their proposed mechanism and functional significance.","questions":[{"text":"What disc, retinal nerve fibre layer, ganglion cell, or optic nerve imaging abnormalities were observed, with which modality and quality limitations?","id":"structural-evidence-and-limitations-q01","kind":"measurement"},{"text":"Could swelling, segmentation error, ocular anatomy, or another eye disease affect interpretation of the structural measurements?","id":"structural-evidence-and-limitations-q02","kind":"boundary"}]}]}]},{"id":"course-and-progression","name":"Course and progression","description":"Distinguishes onset, episodes of injury, recovery, and lasting impairment.","layers":[{"id":"onset-and-episodes","name":"Onset and episodes","description":"Represents disease timing independently of appointments and treatment encounters.","findings":[{"id":"disease-timeline","name":"Disease timeline","description":"Record first symptoms, objective abnormalities, eye involvement, and boundaries between suspected episodes.","questions":[{"text":"When did symptoms and objective abnormalities begin in each eye, and how certain are those dates?","id":"disease-timeline-q01","kind":"provenance"},{"text":"Does later deterioration represent continuation, recurrence, involvement of the other eye, or an unrelated process?","id":"disease-timeline-q02","kind":"boundary"}]}]},{"id":"longitudinal-interpretation","name":"Longitudinal interpretation","description":"Assesses whether serial findings demonstrate clinically meaningful change.","findings":[{"id":"activity-versus-residual-loss","name":"Activity versus residual loss","description":"Distinguish evidence of ongoing injury from established loss and measurement variation.","questions":[{"text":"Which comparable serial examinations demonstrate deterioration, recovery, or stability, and what change threshold was used?","id":"activity-versus-residual-loss-q01","kind":"measurement"},{"text":"What supports current disease activity rather than residual atrophy or persistent visual impairment from an earlier injury?","id":"activity-versus-residual-loss-q02","kind":"definition"}]}]}]},{"id":"clinical-action-and-outlook","name":"Clinical action and outlook","description":"Connects the evidence profile to attributed clinical pathways and an uncertainty-aware outlook.","layers":[{"id":"urgency-and-investigation","name":"Urgency and investigation","description":"Represents assessment priorities and the evidence needed to resolve actionable uncertainty.","findings":[{"id":"cause-dependent-assessment","name":"Cause-dependent assessment","description":"Bind escalation and investigation decisions to a documented pathway and the observed presentation.","questions":[{"text":"Do the onset pattern, rate of visual change, associated symptoms, or suspected mechanism meet a named pathway's criteria for urgent assessment?","id":"cause-dependent-assessment-q01","kind":"action"},{"text":"Which next investigation would distinguish plausible causes or change management, and who is responsible for interpreting it?","id":"cause-dependent-assessment-q02","kind":"action"}]}]},{"id":"management-and-prognosis","name":"Management and prognosis","description":"Records the basis for management choices and expectations about future vision.","findings":[{"id":"mechanism-specific-options","name":"Mechanism-specific options","description":"Separate actions aimed at the cause, prevention of further injury, and support for established visual impairment.","questions":[{"text":"Which management options are supported for the established or suspected cause, under what clinical authority and constraints?","id":"mechanism-specific-options-q01","kind":"action"},{"text":"What evidence supports expectations for recovery, further loss, fellow-eye involvement, or rehabilitation needs, and how applicable is it to this case?","id":"mechanism-specific-options-q02","kind":"provenance"}]}]}]},{"id":"evidence-and-external-alignment","name":"Evidence and external alignment","description":"What the world already says about this thing, gathered so the model can be checked against it.","layers":[{"id":"reported-evidence","name":"Reported evidence","description":"Findings from the breadth pass, kept separate from the structural claims.","findings":[{"id":"evidence-confidence-notes","name":"Check these first","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these check these first hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-confidence-notes-q01","kind":"provenance"}]},{"id":"evidence-kinds","name":"Kinds and varieties","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these kinds and varieties hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-kinds-q01","kind":"provenance"}]},{"id":"evidence-identifiers","name":"Identifiers and schemes","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these identifiers and schemes hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-identifiers-q01","kind":"provenance"}]},{"id":"evidence-standards-and-regulation","name":"Standards and regulation","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these standards and regulation hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-standards-and-regulation-q01","kind":"provenance"}]},{"id":"evidence-real-world-use","name":"Real-world use","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these real-world use hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-real-world-use-q01","kind":"provenance"}]},{"id":"evidence-measurements","name":"Typical measurements","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these typical measurements hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-measurements-q01","kind":"provenance"}]},{"id":"evidence-failure-modes-and-hazards","name":"Failure modes and hazards","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these failure modes and hazards hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-failure-modes-and-hazards-q01","kind":"provenance"}]},{"id":"evidence-regional-variation","name":"Regional variation","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these regional variation hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-regional-variation-q01","kind":"provenance"}]},{"id":"evidence-neighbours","name":"Neighbouring kinds and how to tell them apart","description":"Recalled without web access and unsourced; every item is a lead to verify.","questions":[{"text":"Which of these neighbouring kinds and how to tell them apart hold for the sense of optic nerve disease this model covers, and on what evidence?","id":"evidence-neighbours-q01","kind":"provenance"}]}]}]}]},"agentConduct":{"may":["Give general information on optic nerve diseases and their warning signs, citing clinical sources.","Urge prompt eye examination when a person reports sudden vision loss or pain on eye movement."],"mustNot":["Diagnose or rule out optic nerve disease without clinical examination.","Recommend medicines or doses not prescribed by a clinician.","Tell a person with sudden vision loss to wait and see.","Share a person's vision or neurological diagnosis without consent."],"requiresHuman":["Decisions on treatment, driving fitness or work restrictions."]},"ethics":{"considerations":["Vision loss affects independence and livelihood; delays in care can make it permanent.","Fitness-to-drive decisions balance personal freedom against road safety."],"affectedParties":["Patients","Families and carers","Other road users"]},"owners":{"steward":"The person whose health it is; clinicians answer for care.","roles":[],"masterSystems":[]},"relations":[{"target":"Q18554635","type":"parent","note":"registry parent class"},{"target":"Q55785426","type":"parent","note":"registry parent class"},{"target":"Q767669","type":"parent","note":"registry parent class"}],"interaction":{"identity":{"applicability":"required","items":["Vercy registry: vr.tr.optic-nerve-disease","Wikidata: Q2879095 (https://www.wikidata.org/wiki/Q2879095)"]},"properties":{"applicability":"not-applicable","items":["Affected eye and anatomical segment: Right, left, bilateral, or undetermined; optic disc, intraorbital, intracanalicular, intracranial, multisegment, or unlocalised","Aetiological classification: Glaucomatous, inflammatory, ischaemic, compressive, infiltrative, infectious, hereditary, toxic, nutritional, traumatic, other, multifactorial, or undetermined","Diagnostic certainty: Suspected, provisional, established, disputed, or excluded, with supporting evidence and criteria source","Visual acuity: Per-eye logMAR or explicitly identified alternative scale, with correction, testing conditions, and date","Visual-field involvement: Per-eye field pattern and test-specific indices, including dB where applicable, with protocol and reliability","Colour vision and pupillary evidence: Named colour-test score; relative afferent pupillary defect present, absent, indeterminate, or unassessed, with side and method","Optic disc and axonal structure: Disc appearance; retinal nerve fibre layer and ganglion cell measurements in micrometres where available, with device, segmentation quality, and date","Temporal course and activity: Onset date or interval; sudden, subacute, or gradual onset; activity uncertain, active, recovering, stable, progressive, or recurrent, with definitions","Associated cause or condition: Links to systemic disease, ocular disease, genetic finding, exposure, trauma, or compressive lesion, with causal confidence","Terminology mapping: ICD or SNOMED CT concept identifier, label, edition or release, jurisdiction, and mapping precision"]},"recognition":{"applicability":"not-applicable","items":[]},"capabilities":{"applicability":"required","items":["Assemble eye-specific evidence supporting or challenging optic nerve localisation.","Compare plausible aetiologies and identify missing evidence without automatically assigning a subtype.","Track functional and structural changes across comparable assessments.","Identify whether documented features meet an attributed clinical pathway for urgent specialist assessment.","Link cause-specific investigation and management options to diagnostic certainty, contraindications, and clinical authority.","Map the supported diagnosis to versioned terminology while preserving broader or narrower mapping uncertainty."]},"hazards":{"applicability":"required","items":["Permanent loss of vision or visual field.","Falls and accidents from impaired sight."]},"interfaces":{"applicability":"required","items":["The International Classification of Diseases, issued by the World Health Organization, provides diagnostic classifications for optic neuritis and other optic nerve disorders."]},"context":{"applicability":"required","items":["Optic nerve disease is a clinical category used in ophthalmology and neurology when investigating impaired visual function.","It groups conditions with different causes that require more specific characterization for diagnosis, documentation and follow-up."]}},"sources":[{"title":"Wikidata item Q2879095: optic nerve disease","url":"https://www.wikidata.org/wiki/Q2879095","note":"identity and sense of the item"},{"title":"Wikipedia: Optic neuropathy","url":"https://en.wikipedia.org/wiki/Optic_neuropathy","note":"general description of the item"}],"openQuestions":["Does the registry intend optic nerve disease to include all glaucomatous optic neuropathies and optic disc disorders, and which existing models must this entry reference to avoid duplication?","Which current ICD-10, ICD-11, and SNOMED CT concepts match this umbrella term and its subtypes in the intended jurisdictions?","Which issuing bodies provide applicable subtype-specific diagnostic criteria, urgency pathways, and progression definitions, and what versions should be adopted?","Which functional and structural measures have sufficiently comparable protocols and validated change thresholds across the intended optic nerve disease subtypes?","What prevalence and prognosis estimates are supported for clearly defined subtypes, populations, and study periods without implying that the umbrella category has one uniform risk profile?"],"resources":{"spec":"/models/things/publications/thing-q2879095/spec.json"},"provenance":{"origin":"thing registry research (pass 2)","builtFrom":["models/things/publications/thing-q2879095/spec.json"],"providers":["Codex"],"researchStatus":"unreviewed","generatedAt":"2026-09-12T11:46:21Z","builder":"tools/build_cards.py@1.0.0"},"completeness":{"sections":{"classifiers":"filled","whatItIs":"filled","purpose":"filled","distinguishingFeatures":"filled","structure":"filled","agentConduct":"filled","ethics":"filled","owners":"filled","relations":"filled","interaction.identity":"filled","interaction.properties":"not-applicable","interaction.recognition":"not-applicable","interaction.capabilities":"filled","interaction.hazards":"filled","interaction.interfaces":"filled","interaction.context":"filled","sources":"filled"},"notes":{"_gate":"Published through the thing publication gate 1.0 on 2026-10-07T10:10:29+00:00: completeness 1.00; sense: Wikidata description; 2 live sources; review by codex: pass","interaction.properties":"Plane XCT: no invented physical properties.","interaction.recognition":"Optic nerve disease is a class of pathological conditions that cannot be reliably identified or distinguished by outward appearance alone."},"score":1.0}}