Abstract
Glaucoma diagnosis and follow-up is based actually in three main pillars: Optic nerve appearance, visual field changes and intraocular pressure values. Optic nerve characteristics are the main clinical sign to include an eye as a glaucoma suspect. The vertical cup/disc ratio (CDR) has long been used in the assessment of the glaucoma suspect, though the wide range of CDR values in the normal population limits its use [1–3]. Cup size is related physiologically to disc size and pathologically to glaucomatous damage[4]. Large optical cupping it is easily found by the general ophthalmologist and is one of the features that shows to a glaucoma specialist that the patient could be loosing optic nerve axons. However there are many patients with large optical cupping that do not have or will never have glaucoma, while there are others with large cups that could have a clear disease. Patients with normal tension glaucoma may remain undetected, without pathological changes in the visual fields[5, 6]. Large cups tested with short-wavelength automated perimetry may show early visual field changes [7].
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