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What does high cup disc ratio mean?

For diagnosis of an eye condition called glaucoma, a high cup to disc ratio is initially what the  Eye Specialist in Lahore sees. This is particularly true for previously undiagnosed cases with no family history of this dangerous eye condition. Read on to know more about glaucoma and high cup disc ratio:

What is glaucoma?

Glaucoma is the eye condition characterized by high cup to disc ratio, peripheral visual field defects, with or without raised intraocular pressures. This eye condition silently takes away vision, affecting the peripheral vision first and gradually affecting the central vision. Therefore, the patient is usually unaware that something is wrong with their eyes. Even though glaucoma can occur at any age, it is more prevalent in the older age group; in fact, it is the leading cause of blindness in those aged 60 and above.

Glaucoma primarily affects the optic nerve, which sends the visual signals to the brain. Damage to this optic nerve can cause irreversible visual loss. Glaucoma is managed with pressure lowering topical medication which can help mitigate optic nerve damage, but no drug can completely cure glaucoma.

There are several types of glaucoma, and other than normotensive glaucoma, these types are related to the causes of increased intraocular pressure in the eye. The intraocular pressure or pressure inside the eye is formed by the fluid called aqueous humor, and is produced by the ciliary body. The aqueous humor drains through the trabecular meshwork and functions to provides nutrition to the structures inside the eyes. Any blockage in the drainage of aqueous humor can raise the intraocular pressure and contribute to glaucomatous changes.

Regular eye exams and treatment regimen helps patients to keep their vision, before long-term irreversible changes can set in.

What are the types of glaucoma?

The types of glaucoma are:

  • Open-angle glaucoma: this is the commonest form of glaucoma. In this type, the drainage system of trabecular meshwork is normal but other factors slow the drainage of aqueous humor from the eye. Over time, this causes the intraocular pressure to rise.
  • Pigmentary glaucoma: in this type of glaucoma, there is blockage in the drainage of aqueous humor because of the pigments flaking off from the iris. This can even occur secondary to vigorous activities like jogging.
  • Phacomorphic glaucoma: this type of glaucoma is related to intumescent cataract that causes secondary closure of the angle and thus, interrupts the drainage of aqueous humor.
  • Normotensive glaucoma: in this type, the intraocular pressure remains normal but the glaucomatous changes are present on the optic disc.
  • Phacolytic glaucoma: a hypermature cataract causes this type of glaucoma.
  • Angle-closure glaucoma: this type of glaucoma is common in the Asian population and causes blocked drainage of the eyes as the angle between iris and cornea is too narrow.
  • Traumatic glaucoma: raised intraocular pressure and blockage of the angle can also occur secondary to trauma injury.
  • Glaucoma associated with intraocular tumors: if the tumors inside the eyes block the outflow of the aqueous humor, it can raise the intraocular pressure. This pressure can also raise due to space occupation by the tumor.

What are the symptoms of glaucoma?

Glaucomatous symptoms include:

  • Halos in the vision particularly around lights
  • Redness in the eyes
  • Pain in the eyes
  • Upset stomach and vomiting
  • Hazy looking eyes

What the risks of glaucoma?

The risk factors of glaucoma include:

  • People aged above 55 years
  • Positive family history of glaucoma
  • Raised intraocular pressure
  • High myopia
  • Asian or Hispanic ethnicity
  • Eye injury
  • Thin corneas
  • History of medications like corticosteroids over long-term

How can glaucoma be prevented?

In people with known risk factors and even diagnosed cases, certain measures can help manage and prevent glaucomatous changes. If these measures are taken in the early stage of glaucoma, vision loss can be slowed and even prevented. These measures include getting regular eye exams, wearing eye protection and taking regular medication. If someone is getting regular detailed ocular examinations, glaucoma can be detected before significant damage to the vision has been done. One of the early signs of glaucoma is the high cup to disc ratio which can be detected with dilated fundoscopy by Dr. Jawaid Memon.


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