Glaucoma Diagnosis = Matching Structure & Function

👁 Glaucoma Diagnosis = Matching Structure & Function

Glaucoma is a disease of the optic nerve characterized by both:

ComponentDescription

Structural	Optic disc cupping, RNFL loss
Functional	Visual field defect (VFD)

✅ Both must be present to confirm a diagnosis.

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🧪 How Pressure Causes Damage

• IOP ↑ targets the Inferotemporal (IT) region of the optic disc
• This leads to damage in the IT RNFL (Retinal Nerve Fiber Layer)
• Resulting in Visual field loss in the superior nasal field5

 

 

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🧠 Structural Mapping: The 1:1:1 Rule

Layer/StructureLinks to

RNFL	Optic Disc
Optic Disc	Optic Nerve
Visual Field	Matches RNFL/Disc

➡️ All regions follow a precise anatomical mapping
→ RNFL ↔ Optic Disc ↔ Visual Field = 1:1:1

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📍 Clinical Matching Example

Damaged AreaVisual Field Effect

Inferotemporal (IT) RNFL	Superior nasal visual field loss
Superonasal (SN) RNFL	Inferior temporal loss

✅ Most common in glaucoma:
IOP ↑ → IT optic disc cupping → RNFL IT loss → upper nasal scotoma

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✅ Summary

• Structure and function must align in glaucoma diagnosis
• Damage to specific optic nerve regions causes corresponding field loss
• Visual field interpretation must account for RNFL-disc mapping
• Especially in glaucoma, Inferotemporal → Upper Nasal VFD is key