Optical nerve cupping

[Tamihart]

I went to an optometrist today for a routine exam ,which is my first in many many  many years.  He said my pressures in the eyes were normal but when he looked into my eyes he saw some optic nerve cupping.  He said do not lose any sleep over this but to see and MD for on OCT test.  My peripheral vision tests were normal.  Any thoughts?  What does this "cupping"  mean?  Thanks

[deb2319]

Would the following be considered catching it early?
   (a) nasal step in one eye (above the midline), some portions down to 14Db (out of normally 28Db), OCT showing 80 microns average vs 85 in the other (unaffected as yet) eye
   (b) IOP 19/19

I.e. even if there is actual field loss  in one eye, but not to the extent of a 'complete" blind spot (i.e. just loss of sensitivity), is that still early?

[Michael J Kutryb, MD]

This is an extremely common situation.  It used to be that the intraocular pressure what the main test for glaucoma.  Now, however, ophthalmologist are very interested in the optic nerve and specifically the neurosensory rim of the nerve and the nerve fiber layer.  By using sophisticated digital imaging, we can now catch glaucoma much earlier than ever before and begin treatment so that patients often lose no vision at all.  Basically, you are now considered a "glaucoma suspect" and further testing will show whether or not you may need to start treatment at some point.  In general you will either be normal and require no treatment or you may have an early case of glaucoma and require treatment.  Even if you end up having an early case of glaucoma at some point, your prognosis should be very, very good.

Michael Kutryb, MD
Board-Certified Ophthalmologist
Titusville, FL

[Michael J Kutryb, MD]

Yes, these tests are usually performed for those considered glaucoma suspects due to any pressure, cupping or visual field chararcteristics suggestive of glaucoma.  Commonly done, yes.

MJK

[Nancy T]

Is this "sophisticated digital imaging" now standard (or commonly used) if your eye pressure is high and/or if you have any "cupping"?

I have both, but the ophthalmologist has never mentioned any other tests except 6-month office follow-ups.

Thanks,

Nancy T.

[Michael J Kutryb, MD]

Call your doctor - that is what they are there for.

MJK

[deb2319]

oh, and forgot to add, no visual cupping/abnormality the specialist could see -- only confirmation was the OCT -- he said visually, the nerve looked "unremarkable."