- Clinical evaluation of the optic disc can be performed via indirect
or direct ophthalmoscopy techniques
- Slit lamp indirect ophthalmoscopy is associated with use of a 78
or 90 diopter handheld lens, a Hruby lens, or a posterior pole contact
lens
- Photographic documentation of the optic disc and retinal nerve fiber
layer is useful for baseline comparison
- Newer disc and/or nerve fiber layer imaging techniques (e.g. OCT,
HRT, GDx) are promising and may assist in clinical evaluation
- Characteristic features of glaucomatous optic nerve include:
- Generalized or focalized increase in the optic cup size and
in the cup-disc ratio
- Vertical enlargement of the optic cup as a result of retinal
nerve fiber loss and/or disc rim loss (especially at the superior
and inferior poles)
- Asymmetric cupping ( 0.2 cup-disc ratio difference) between
the two eyes
- Changes in vessel configuration and caliber
- Splinter hemorrhages
- Increased visibility and thinning of the lamina cribrosa
- Narrowing or notching of the neural rim
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