Abstract
The perplexing subject of optic nerve head (ONH) damage and visual field defects in glaucoma is discussed very briefly. Most of the views on the subject can be broadly classified into either the vasogenic or the mechanical concept. For a proper understanding of the vasogenic concept, it is essential to have a thorough grasp of the marked complexities of the blood supply of the ONH; this is briefly summarized. The vasogenic and mechanical concepts are summarily reviewed. The various risk factors responsible for the interindividual variation in susceptibility to pressure-related ONH damage are mentioned. From the available evidence it can be concluded that the ONH damage in primary open angle glaucoma (POAG), low-tension glaucoma (LTG), and allied disorders is multi-factorial in origin, and most of the evidence strongly suggests vascular disturbance in the ONH as the principal culprit.
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