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Ophthalmology and Visual Sciences

Optic Disc Notch and Retinal Nerve Fiber Layer Defect in Primary Open Angle Glaucoma

Optic Disc Notch and Retinal Nerve Fiber Layer Defect in Primary Open Angle Glaucoma

Category(ies): Glaucoma, Iris
Contributor: Jesse Vislisel, MD
Photographer: Jill Oulman

Primary open angle glaucoma of the left eye.

Fundus photos
The optic nerve shows moderate cupping but there is a prominent inferior notch. The normal sheen of the nerve fiber layer is absent in a distribution radiating temporally from this notch due to cellular loss. The notch and nerve fiber layer defect can be more easily visualized on optical coherence tomography.
humphrey examine
Humphrey visual field shows a corresponding superior arcuate scotoma.