Clinical significance of hemorrhages in the optic disc

A consecutive series of 8029 first visit optometric examinations revealed 20 patients having hemorrhages of the optic disc. Assessment of optic disc contour, intraocular pressure (IOP), and visual fields was undertaken at detection of the hemorrhage and at follow-up not less than 3 months later. The disc hemorrhage patients were assessed for the presence of systemic occlusive disease. The sensitivity of disc hemorrhage as a sign of glaucoma was 0.3 in the sample. There was some risk of visual field loss after detection of a hemorrhage in eyes having glaucoma (1 of 6 eyes); a similar risk was observed in non-glaucomatous eyes in which bleeding occurred (4 of 14 eyes). Hemorrhages occurred in 8 eyes that remained clinically normal during the course of follow-up. Notching of the neural rim of the disc was common but overall changes in contour of the disc were observed in only one patient. An association between disc hemorrhage and systemic disease could not be established.