Evaluation of the optic nerve head in glaucoma

Abstract

Glaucoma is an optic neuropathy leading to changes in the intrapaillary and parapaillary regions of the optic disk. Despite technological advances, clinical identification of optic nerve head characteristics remains the first step in diagnosis. Careful examination of the disk parameters including size, shape, neuroretinal rim shape and pallor; size of the optic cup in relation to the area of the disk; configuration and depth of the optic cup; ratios of cup-to-disk diameter and cup-to-disk area; presence and location of splinter-shaped hemorrhages; occurrence, size, configuration, and location of parapapillary chorioretinal atrophy; and visibility of the retinal nerve fiber layer (RNFL) is important to differentiate between the glaucomatous and nonglaucomatous optic neuropathy.