Retinal nerve fibre layer photography in glaucomatous patients

Retinal nerve fibre layer photographs were obtained from sixty-three patients, (113 eyes), attending a glaucoma suspect clinic at Moorfields Eye Hospital. These photographs were studied following masking of the optic disc. Interobserver error was good. Intraobserver error following a six-month 'learning period' showed changes in identification of nerve fibre layer defects occurring as a result of the learning process. Humphrey threshold fields on the 113 eyes were independently scored as abnormals, suspect or normal. A good correlation existed between defects visible on the retinal nerve fibre layer photograph and 'abnormal' visual fields. Retinal nerve fibre layer photography is possible in glaucoma patients with clear optical media whose pupils permit full mydriasis. It seems to supplement other methods of assessing the early glaucoma patient. It may be of value in sequential follow-up. It would seem to be of little value in the majority of elderly glaucoma patients who would have opacities in the optical media.