Evaluating the optic nerve for glaucomatous progression

Identification of progressive glaucomatous damage to the optic disc is one of the most important aspects of glaucoma management, yet it remains largely subjective and imprecise. Progressive change in the appearance of the optic disc or retinal nerve fiber layer (RNFL) often precedes the development of visual field defects in glaucoma. Because visual field defects on standard automated perimetry may only be detected after a substantial number of nerve fibers has been lost, assessment of the optic disc and RNFL is essential for monitoring the initial stages of the disease. Before the development of visual field defects, structural changes in the optic disc or RNFL may be the only evidence for the ophthalmologist that the glaucoma is progressing and treatment needs to be intensified. Even in the presence of visual field defects, progression of optic disc damage may occur without any detectable evidence of functional deterioration. © 2010 Springer-Verlag New York.

Duke Scholars

Author Felipe Medeiros Ophthalmology, Glaucoma