4 Topic Commentaries

Clues It May Not Be Glaucoma

• 

  Wallace L. M. Alward, MD

  Glaucoma

  •

  University of Iowa Carver College of Medicine

  Glaucoma is almost unique among optic neuropathies in that it results in cupping rather than pallor of the optic nerve head.

  Source
• 

  Lilly H. Wagner, MD

  Oculoplastic & Orbital Surgery (Ophthalmology)

  •

  Mayo Clinic (Rochester, Minnesota)

  …patients who are around 50 years of age or younger, I'm going to be very highly suspicious, especially if I see a strange optic nerve, checking color vision in these patients just to monitor if one eye is going to have a deficit compared to the other, checking for an APD myself… and then really being hyper-aware of both visual field defects that are respecting that vertical midline… but really paying attention to that vertical midline and then pallor.

  Source
• 

  Kenn A. Freedman, MD, PhD

  Neuro-Ophthalmology and Oculoplastic Surgery

  •

  Texas Tech University Health Sciences Center

  NTG is fairly common, but your suspicion for something else should be elevated when: - younger person with optic atrophy or cupping - color vision loss (glaucoma does not have color vision loss early on) - Pallor of disc rim (pallor not usually seen in early glaucoma) - VF loss out of proportion to the cupping present

  Source
• 

  Jonathan D. Trobe, MD

  Neuro-Ophthalmology

  •

  University of Michigan Medical School, Kellogg Eye Center

  Optic disc pallor could mean many kinds of optic neuropathy, including ongoing compression by orbital or intracranial tumor, previous inflammation, trauma, infarction.

  Source