Tilted disc
 

The opitc disc is elevated and the inferonasal disc is  posteriorly displaced, giving an oval-appearing optic disc.  There is inferonasal peripapillary crescent and situs inversus of the vessels as they emerge from the disc.  Look for: high myopia or moderate oblique myopic astigmatism in the patient's glasses

Questions:

1. What is the significance of tilted disc?

Answer
Although the condition has no systemic or neurologic association, the visual field may show bitemporal field defects which are usually confined to the superior quardrant. Unlike chiasmal lesion, the field defect does not obey the midline.
The field defect is thought to be the result of refractive scotoma as a result of regional myopia confined to the inferonasal retina. Repeating the field with -4.00 D lens often eliminates the field defect.

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