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Optic disc and visual field changes in primary open angle glaucoma.

¹Department of Ophthalmology, Prince of Wales Hospital & University of New South Wales, Randwick.

Australian Journal of Ophthalmology

|August 1, 1981

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Early detection of primary open angle glaucoma (POAG) damage is crucial. Combining optic disc review and visual field testing with tonometry aids in identifying early glaucomatous damage for effective patient management.

Area of Science:

Ophthalmology
Glaucoma Research
Optic Nerve Health

Background:

Accurate detection of glaucomatous damage is essential for optimal patient management.
Tonometry alone is insufficient for monitoring glaucoma therapy effectiveness.

Purpose of the Study:

To outline key indicators for early detection of primary open angle glaucoma (POAG).
To emphasize the necessity of combining multiple diagnostic methods for comprehensive glaucoma assessment.

Main Methods:

Stereoscopic optic disc review.
Quantitative perimetry for visual field analysis.
Examination for specific visual field defects like nasal steps and paracentral scotomata.

Main Results:

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Early signs of POAG optic nerve head damage include nerve fiber layer hemorrhage, generalized and localized optic cup enlargement.
Localized optic cup enlargement and nerve fiber layer hemorrhage are absolute indications for initiating or intensifying ocular hypotensive therapy.
Specific early visual field changes in POAG include paracentral scotomata, nasal steps, and concentric isopter contraction.

Conclusions:

A combination of tonometry, stereoscopic optic disc review, and quantitative perimetry is necessary for effective glaucoma management.
Identifying specific optic nerve head and visual field changes allows for timely therapeutic intervention in POAG.