Diagnosis based on optic disc evaluation involves care
How to recognise typical optic disc features in early disease
Cheryl Guttman Krader
Published: Saturday, September 14, 2019
[caption id="attachment_16503" align="alignleft" width="1024"]
Francisco Goñi[/caption]
ATTENTIVE evaluation of the optic disc in clinical practice provides invaluable information for diagnosing glaucoma, but establishing a diagnosis of glaucoma based on optic disc appearance usually requires the combination of different signs, said Francisco Goñi MD at the ESCRS/EGS Glaucoma Day meeting.
In his talk, Dr Goñi discussed how to recognise typical optic disc features in early disease.
Through his discussion and a series of clinical examples, however, he showed how various “typical” features can lack specificity for glaucoma and thus the need to place individual findings in the context of a complete examination.
“When a sign is detected, search carefully for other signs,” said Dr Goñi, Barcelona, Spain.
To evaluate the optic disc, he recommended that the examination be performed through a dilated pupil and before knowing findings from IOP measurement and OCT imaging.
“If you know the patient’s IOP and OCT, you will be biased to judge the optic disc,” he explained.
Then, clinicians should follow a systematic approach, evaluating the size, cupping, rim, vessels and retina parapapillary region, and they should always compare the appearance of the optic disc between eyes.
Dr Goñi also reminded attendees about the importance of obtaining images of the optic disc for documentation and follow-up.
Francisco Goñi[/caption]
ATTENTIVE evaluation of the optic disc in clinical practice provides invaluable information for diagnosing glaucoma, but establishing a diagnosis of glaucoma based on optic disc appearance usually requires the combination of different signs, said Francisco Goñi MD at the ESCRS/EGS Glaucoma Day meeting.
In his talk, Dr Goñi discussed how to recognise typical optic disc features in early disease.
Through his discussion and a series of clinical examples, however, he showed how various “typical” features can lack specificity for glaucoma and thus the need to place individual findings in the context of a complete examination.
“When a sign is detected, search carefully for other signs,” said Dr Goñi, Barcelona, Spain.
To evaluate the optic disc, he recommended that the examination be performed through a dilated pupil and before knowing findings from IOP measurement and OCT imaging.
“If you know the patient’s IOP and OCT, you will be biased to judge the optic disc,” he explained.
Then, clinicians should follow a systematic approach, evaluating the size, cupping, rim, vessels and retina parapapillary region, and they should always compare the appearance of the optic disc between eyes.
Dr Goñi also reminded attendees about the importance of obtaining images of the optic disc for documentation and follow-up.
Tags: European Glaucoma Society, glaucoma
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