Unhelpful

[Ruthiejb]

This is the most unhelpful response I've ever seen.  How would she know what her pressures are if not under the care of an opthalmologist?  

This discussion is related to Glaucoma suspect criteria.

[Ruthiejb]

I can't thank you enough for your response, Dr. Vosoghi.  I am Caucasian with Eastern European ancestry.  My opthalmologist administers a visual field test once per year (which I dread) and HRT; there has been no change so far.  I'm one of those people who stresses over the visual field test and would rather not take it, but I do understand the need.  Again, thank you very much.

[Houman Vosoghi, MD]

0.5 is not too big of a deal and if you were african american, native american, or hispanic it would be considered almost normal.  In caucasians, I have only seen nerves 0.5 or greater regularly in those with ancestry in certain parts of Spain and Ireland.  It could still be normal and physiologic in certain families, especially if the nerve size overall is large.  I would probable get seen every six months or so and alternatively perform visual fields and OCT nerves along with a dilated exam to check for evidence of progression.  If nothing ever changes, you probably don't have glaucoma and were born with such cupping of the nerves.  You lose nothing by being careful and monitoring regularly.  This is why we consider people with large cup to disc ratios glaucoma suspects; so we can monitor frequently enough to make sure we would not miss a potentially blinding disease in any of our patients.

HV

[Ruthiejb]

I meant to also post that the cup to disc ratio is .5 in both eyes.  Thank you again.

[Ruthiejb]

Thank you very much, Dr. Vosoghi.  I appreciate your very helpful response.  

[Houman Vosoghi, MD]

Just saw your post from a couple of years back.  It depends what the cup to disc ratio is but safer to be considered a glaucoma suspect so all appropriate testing can be repeated at regular intervals to ensure progression would be caught.  OCT is considered more reliable than HRT by most glaucoma docs these days for diagnosing glaucoma.  Even with low pressures, normal tension glaucoma is a possibility.

HV

[John C Hagan III, MD, FACS, FAAO]

-

[Ruthiejb]

This comment was supposed to be in response to another post but I guess that post was closed to comments.  It referred to a very unhelpful response to a question asked a while back.