Does large cupping of optic nerve mean glaucoma

[ladiny]

I got poked in the eye by a kid so I decided to go to an opthamalogist to get it checked out. It was fine. My vision, eye pressure was fine. He noticed that my optic nerve cupping was 60% on both eyes. I am 40. I have no family history, don't wear glasses and have had no vision problems ever. He suggested that I may have just been born with it larger ones. He told me to come back within 3 months for a vision field test. Is this anything to worry about? Is it common to have larger cupping? Help!

[Michael J Kutryb, MD]

The doctor can determine if you need to be on treatment for glaucoma by evaluating the optic nerve, nerve fiber layer, visual field, corneal thickness and intraocular pressure.  At best you are just a low risk glaucoma suspect.  At worst you could have an early, mild case of glaucoma and might need to start drop or laser treatment at some point.  The important thing to know is that as long as you are under proper treatment, for most people with glaucoma, the risk of significant vision loss is low.  I see people every day who have enlarged optic nerve cupping but normal pressure.  We call them glaucoma suspects and do all the usual testing and don't consider treatment unless there are other abnormalities other than the cupping.

Michael Kutryb, MD