Optic atrophy can be caused by different pathogenic changes of the retina and optic nerve such as inflammation, degeneration, ischemia, trauma, compression, poisoning and tumor. The specific examples are retinal pigment degeneration, chorioretinitis, demyelinating disease, optic neuritis, papilloedema, disease of the retinal vessels, drug or heavy metal poisoning, compression from the intracranial space-occupying lesions, hereditary disease, Leber's optic neuropathy, syphilis, trauma of the optic nerve, glaucoma and so on.

Although optic atrophy is the final results of retinal and optic troubles, different eyeground diseases and some hereditary changes may also cause the disease, which is classified into primary, secondary and ascending types according to the different indications of the part of lesion and the affection to the optic disc under the ophthalmoscope.

The disease should pertain to "Qingmang" (optic atrophy) in traditional Chinese medicine. Although knowledge on optic atrophy in TCM can be traced back to the ancient times, its cause and pathogensis, in a word, is nothing more than the various factors which finally lead to the obstruction of ocular pores (tissues) so that visual diminishment or loss occurs. Its specific causes, however, are of quite variety. When asthenia of essence and blood, because of congenital defect or deficiency of the liver and kidney, can not have the eye nutritioned, for instance, the optic disc may become atrophic and the eyesight falls down.
When the depression of seven emotions and stagnation of liver qi results in stagnancy of qi and blood circulation and blockage of pores, the vision may be blinded.

If the trauma of eye and head involves the ocular connectors to cause obstruction of collaterals, the essence and blood cannot move up to the eye, giving rise to blindness or blurred vision. Or when the obstruction of meridian by wind-phlegm blocks the ocular pores (tissues),  the vision can also be blurred or darkened.