Opticdisc

Question 1

ISNT” rule

Answer 1

I: Inferior rim, thickest
S: Superior rim
N: Nasal rim
T: Temporal rim, thinnest

Question 2

In glaucoma, the ———- rims are affected first

Answer 2

In glaucoma, the inferior and superior rims are affected first

Question 3

C/D ratio is diagnostic?

Answer 3

There is not a specific C/D ratio that is diagnostic of glaucoma. However, a general rule of thumb is that ~0.6 or greater is suspicious. Only about 5% of individuals without glaucoma have a C/D ratio of >0.6

Question 4

In a healthy eye, the horizontal C/D ratio is typically—- than the vertical C/D ratio

Answer 4

greater

Question 5

vertical C/D ratio and glaucoma

Answer 5

suggesting that the vertical C/D ratio increases faster in early and intermediate glaucoma. Some specialists evaluate the disc rim rather than focusing on the C/D ratio.

Question 6

Blood vessels can also be affected in glaucoma

Answer 6

Bayonetting and nasalization of vessels

Both attenuated vessels and optic disc hemorrhages (also known as Drance or splinter hemorrhages) can also occur

Question 7

bayonetting of vessels

Answer 7

appearance of kinked or sharply turned vessels as they advance over the edge of the cup.

Question 8

Asymmetry of the C/D

Answer 8

Asymmetry of the C/D greater than 0.2 occurs in less than 1% of healthy individuals. The presence or absence of asymmetry between the optic nerves of each eye can be helpful when comparing the nerves.
past trauma in an eye can lead to angle recession glaucoma, which presents unilaterally.

Question 9

Optic nerve color

Answer 9

In glaucoma, the color of the optic disc is usually preserved unless the patient has advanced stage glaucoma. Pallor can indicate that a secondary optic neuropathy is present, such as optic neuritis or a compressive lesion.

Question 10

Peripapillary atrophy

Answer 10

The beta zone is the area that directly borders the disc, while the alpha zone is located more peripherally.6 Hypo or hyper pigmentation can be visualized in the alpha zone, but these pigment irregularities in the alpha zone typically are not pathologic in healthy eyes.

Question 11

an alpha zone and beta zone

Answer 11

Hypo or hyper pigmentation can be visualized in the alpha zone, but these pigment irregularities in the alpha zone typically are not pathologic in healthy eyes

Question 12

Beta zone

Answer 12

peripapillary atrophy in the beta zone with glaucoma. In the beta zone, large choroidal vessels become visible. These differences in location can present with different visual field defects

Question 13

Optic disc tilting

Answer 13

Optic disc tilting occurs due to mechanical stress on the peripapillary sclera. Tilting can be congenital or secondary to another condition like glaucoma. A tilted disc is not necessarily pathologic. Tilting is heavily associated with myopic eyes and may be protective against glaucomatous progression in myopic patients

Question 14

Pic

Answer 14

A tilted disc will appear vertically elongated and at an oblique angle. It can be challenging to diagnose glaucoma in myopic eyes as the disc appears elongated and tilted

Question 15

Vessel baring

Answer 15

retinal tissue loss occurs and the rim narrows, these vessels may be exposed and appear suspended above the edge of the cup. While this sign isn’t specific to glaucoma it is also associated with glaucomatous damage