how fast is glaucoma progresion?

I have "suspect glaucoma".   If the cup size on my optic nerve has increased from .6mm to .8mm in a year, is that rapid deterioration, or merely a possible reason to diagnose glaucoma?

[John C Hagan III, MD, FACS, FAAO]

Determining cup size of the optic nerve also known as the cup/disk ratio, is notoriously difficult to do consistently. Studies have shown marked variation not only from one skilled observer to another (looking at the same optic nerve) but also from the same observer.   A more accurate measurement can be done useing stero disk photographs. Lastly a new instrument OCT (optical coherence tomography) is revolutionizing the diagnosis of glaucoma by measuring the thickness of the nerve fiber layer of the retina around the optic nerve. It is very accurate and very reproducible.

With that back-ground if you in fact had a true .6 cup last year and this year its truly .8 then that is extremely alarming and would suggest the need for intense glaucoma treatment. If not under the care of an ophthalmologist skillful and experienced in glaucoma I would recommend you do so immediately. You also need a full court glaucoma work-up: corneal thickness, optic nerve photographs, visual fields, gonioscopy, OCT and frequent office visits at the Eye MDs.

JCH III MD  Fellow in the American Academy of Ophthalmology and the American College of Surgeons.