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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
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First of all, thank you so much for offering this service.

Resolved Question:

First of all, thank you so much for offering this service. As I am sure you hear daily, I am terrified with the idea that I am a candidate for glaucoma and now after researching the web and panicking, it is so nice to have someone to ask questions to.
Yesterday at my annual optometry appointment, my doctor indicated he was slightly concerned b/c the cup/disc ratio in one eye was .41 compared to .2 in the other. Additionally, in the .41 eye he noticed some minor defects in my retinal nerves. He said this could be a possible indication of glaucoma, it was not a definite indicator.
However, all night I have been wondering what that really means, what I need to do next to find out if it is glaucoma and if there is any preventative measures I can be taking.
Do you have any advice for what the odds of this being a sign of glaucoma are? Is there a next step I should be taking? I have requested past eye exam records and am sending them into my current doctor. But, what else should I know and most importantly what is the significance of my cup/disc ratio?
Thank you sooo much!
Submitted: 7 years ago via Glaucoma Research Foundation.
Category: Eye
Expert:  Dr. James replied 7 years ago.

Is your optometrist doing any other tests?
What were your eye pressures?
Do you have a family history of glaucoma?
Have you had any eye surgery?
Customer: replied 7 years ago.

He is waiting to see my past eye exams to see if my cup/ratio was normal at one time. We have another appointment scheduled but no immediate action planned.

Not sure what my eye pressure was, he didnt mention it so I am assuming they were within normal range. I can find that out.

No family history.

No eye surgery.

Expert:  Dr. James replied 7 years ago.

It is true that an asymmetry in the optic cup can be an indication for glaucoma. A 0.2 cup is considered normal. Most people's optic nerves or fairly symmetric. So the thought is that the right eye was a 0.2 in the past as well and has now become a 0.4 cup.

This is not always the case. There are some people who just have asymmetric optic nerves. If it has always been that way, then there is no glaucoma. That is why your doctor is waiting on past exams.

There are other tests which can be done to assess the thickness of the nerve fiber layer. A common test is called an OCT. Additionally, glaucoma can result in a loss of peripheral vision or blind spots. A visual field test will look for this.

Other risk factors include family history, eye surgery such as cataract surgery as a child, high eye pressure, and age over 40.

Your age of 26 makes it unlikely that you have glaucoma. Additional test such as a visual field test and OCT can help alleviate any concerns. Yearly exams can help monitor for any changes to the optic nerves as well.

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