Epidemic Bhutanese Optic Atrophy

Beginning in the early 1990's, tens of thousands of ethnic Nepali Bhutanese were forced out of Bhutan as a result of the Bhutanese; government's policy of "one nation and one people." A majority of these persons resided, for up to twenty years, in camps along the; Eastern Nepal border with Bhutan before resettlement in third-party countries. Vitamin B12, among other micronutrient; deficiencies, was common in these camps. More than 100,000 individuals have been resettled, with over 80% coming to the United; States, with less than 3,000 Bhutanese refugee arriving in Vermont. A number of patients from the local Bhutanese refugee population were evaluated in the neuro-ophthalmology clinic at our academic medical center and found to have optic atrophy (OA) without identifiable cause. To better understand the scale and potential etiology of this problem, all cases of OA, from this group, referred to the neuro-ophthalmology clinic, were reviewed.