  Aims. The objective of this paper is to determine the incidence of ophthalmic
disease potentially leading to optic nerve disease in Middle Tennessee.
Methods. We use a retrospective population-based incidence study design
focusing on the population of middle Tennessee and its nearby suburbs (N=3 397
515). The electronic medical records for all patients evaluated or treated at a
large tertiary care hospital and clinics with an initial diagnosis of a disease
either affecting the optic nerve, or potentially associated with optic nerve
disease, between 2007 and 2014 were retrieved and analyzed. Results. 18 291
patients (10 808 F) with 18 779 incidence events were identified with an age
range of 0-101 years from the query of the Vanderbilt BioVU. Estimated
age-adjusted incidence per 100 000 population per year was 198.4/145.1
(glaucoma F/M), 14.4/11.4 (intrinsic optic nerve disease F/M), 10.6/5.8 (optic
nerve edema F/M), 6.1/6.6 (orbital inflammation F/M), and 23.7/6.7 (thyroid
disease F/M). Glaucoma incidence was strongly correlated with age with the
incidence sharply increasing after age 40. Optic nerve edema incidence peaked
in the 25-34 old females. African American population has increased likelihood
of glaucoma, orbital inflammation, and thyroid disease. Conclusions. Mapping
the incidence of pathologies of the optic nerve is essential to the
understanding of the relative likelihood of these conditions and impacts upon
public health. We find incidence of optic nerve diseases strongly varies by
gender, age, and race which have not been previously studied using a unified
framework or within a single metropolitan population
