glaucoma

[sarah43]

if someone has glaucoma damage at what c/d would a patient notice change in peripheral vision??

[sarah43]

thanks for detailed answer just that it  could be 3  months before i see glaucoma  specialist and from no cupping to 0.5 in 6 months is bit worrying with pressures at 25 in both eyes, cornear thickness is slightly thicker than normal so that must be a good thing ??

[Michael J Kutryb, MD]

It has more to do with the condition of the neurosensory rim and the retinal nerve fiber layer.  It also has a lot to do with other factors like corneal thickness, nerve fiber thickness, and pressure and vascular health of the eye and optic nerve.  It's not as cut and dry as you want to make it out to be.  In general, the more damage that occurs to the neurosensory rim and nerve fiber layer, the greater the degree of visual field loss.  Remember, that in some cases people can have c/d ratio of 0.8 or nearly 0.9 and still have nearly normal visual field results while in others the c/d ratio can be much better and visual field defects may be present.  There are no definite rules, but in general, the more extensive the cupping, the greater chance of visual field loss.  It is the whole, big picture of visual field testing, retinal nerve fiber testing, optic nerve scans, pachometry, and intraocular pressure that go into the proper management of glaucoma.

MJK MD