Adrenoleukodystrophy (ALD) is a genetic disorder characterized by the progressive loss of the protective protein coat called the myelin sheath surrounding nerve fibers. Without this protective coat, the nerve fibers become fragile and more likely to be damaged.

ALD also frequently affects the adrenal glands, causing adrenal insufficiency when these glands fail to secrete enough of some hormones.

Although eye exams are not specifically used as a diagnostic tool for ALD, the condition can affect the eyes, and regular eye exams can be used to assess the progression of the disease. Eye exams can also help determine whether a patient’s corticosteroid replacement therapy is working effectively.

What is an eye exam?

During a normal dilated eye exam, an optometrist or ophthalmologist uses a treatment that temporarily dilates the eye (expands the pupil so that the back of the eye may be visualized). With the pupil dilated, the physician can visually examine the optic nerve and assess the extent of neurodegeneration. The dilation, which lasts for a few hours, generally does not cause any discomfort aside from mild light sensitivity.

What information can be gathered during an eye exam?

For some ALD patients, there may not be any symptoms outside of vision loss in the early stages of the disease.

It is also important that an optometrist assesses whether corneal ulcers (a sore on the cornea) or cataracts (clouding of the lens) are developing.

Corticosteroid replacement therapy can suppress the immune system, which may make patients more susceptible to eye infections. This can also be monitored during an eye exam.

How long does it take to get the results of an eye exam?

Patients usually receive the results of their eye exam on the same day. The optometrist or ophthalmologist will meet with both patients and their caregivers to discuss these results and any treatments or changes in treatments they recommend based on the exam results.


Adrenoleukodystrophy News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.