Table 2.

Responses deemed as having major inaccuracies with any potential for harm

Question	Response	Reason for harm
What is optic disc drusen?	“Optic disc drusen is a condition in which small, whitish-yellow deposits of calcium or other minerals accumulate within the optic nerve head. This can cause varying degrees of vision loss or visual field defects, as well as other symptoms like headaches or eye pain.”	This response indicates that headache and eye pain may be caused by ODD. This is not only inaccurate but may also delay a diagnosis of other reasons for headache and eye pain, which may even require timely treatment, and is therefore a response with potential for harm
Is optic disc drusen treatable?	“Unfortunately, there is no known cure for optic disc drusen. However, the symptoms can be managed with regular eye checkups, monitoring of vision changes, and treating associated eye conditions such as glaucoma or anterior ischemic optic neuropathy if they arise. In rare cases where optic disc drusen cause severe vision problems, surgical options may be explored, although the success rate of these procedures is not well established. It is important to speak with an ophthalmologist for individualized recommendations and management of optic disc drusen.”	This response indicates that surgery may be a treatment option for ODD. This is inaccurate and may lead to patients seeking and exploring surgical options from dubious healthcare providers and is therefore a response with potential for harm
Is optic disc drusen treatable?	“There is no known cure for optic disc drusen, but treatment is usually focused on monitoring the condition and managing any associated symptoms. Your doctor may recommend regular eye exams to track any changes in your vision, as well as imaging tests like optical coherence tomography (OCT) or visual field testing. In some cases, treatment may be recommended to alleviate symptoms such as visual disturbances or headaches. This may include medications or eyeglasses to help with focusing or reducing glare, or other vision aids. In rare cases where optic disc drusen are causing significant vision loss, surgery may be considered, although this is not often recommended. It's important to follow your doctor's advice and attend all recommended check-ups to ensure that any changes to your vision can be detected and managed appropriately.”	This response indicates that surgery may be a treatment option for ODD. This is inaccurate and may lead to patients seeking and exploring surgical options from dubious healthcare providers and is therefore a response with potential for harm
Can optic disc drusen impact my vision?	“Yes, optic disc drusen can affect your vision. Optic disc drusen are deposits that accumulate in the optic nerve head of a person's eye. These drusen can significantly impact visual function and lead to a range of symptoms, including peripheral visual field loss, blurred or distorted vision, double vision, or visual anomalies such as blind spots or scotomas. Although optic disc drusen are not associated with any specific eye disease, they can increase the risk of developing glaucoma, a condition that can cause permanent damage to the optic nerve if left untreated. Therefore, if you experience any vision-related symptoms, it is essential to consult an eye doctor for proper diagnosis and treatment.”	This response states that optic disc drusen can increase the risk of developing glaucoma. This is not only inaccurate but may also lead to life-long, expensive, and unnecessary anti-glaucoma treatment, including surgery, and is therefore a response with potential for harm
Can optic disc drusen lead to other diseases?	“Optic disc drusen (ODD) are small, hyaline deposits of calcium found within the optic nerve head. While ODD itself is not considered a disease, having it may increase the risk of developing certain eye conditions. These potential conditions include: 1. Anterior Ischemic Optic Neuropathy (AION): AION occurs when blood flow to the optic nerve is compromised, causing optic nerve damage and vision loss. People with ODD may be at an increased risk of developing AION 2. Non-arteritic anterior ischemic optic neuropathy (NAION): NAION is a sudden loss of vision in one eye that can occur without warning. It may be associated with underlying vascular diseases like diabetes, hypertension, high cholesterol or pre-existing optic nerve abnormalities 3. Glaucoma: ODD can mimic glaucomatous optic neuropathy by causing cupping of the optic nerve head which can lead to excessive eye pressure 4. Pseudo-optic atrophy: ODD can also lead to optic disc swelling and shrinkage which may resemble optic atrophy While these risks are present, they are not very common. People who have ODD will need regular eye exams to monitor their eye health over time. If you have any concerns about your eye health, talk to an eye care professional to help understand your risks and how best to manage them.”	This response lists both anterior ischemic optic neuropathy (AION) and non-arteritic anterior ischemic optic neuropathy (NAION), which gives the impression that these are two different disease entities. NAION is a subgroup of AION that is non-arteritic. Another subgroup of AION is arteritic AION, often abbreviated as AAION, which is a different disease entity related to arteritic disease such as giant cell arteritic. Stating AION and NAION as two separate diseases may confuse and lead to an understanding of AAION being related to ODD, which may delay important time of diagnosis and treatment for AAION and is therefore a response with potential for harm. Also, the response states that ODD can cause cupping of the optic nerve head mimicking glaucomatous optic neuropathy. This is not only wrong, but may also lead to life-long, expensive, and unnecessary anti-glaucoma treatment, including surgery, and is therefore a response with potential for harm. Finally, the response states that ODD can lead to pseudo-optic atrophy, since they can both cause optic disc swelling and shrinkage. The term pseudo-atrophy is not an established term among physicians, and it is inaccurate and confusing. Also, optic nerve shrinkage is an imprecise terminology potentially also leading to unnecessary auxiliary workup and a potential for harm