Venkitasubranayan Mallika1 , Vaikkakara Sudha2
BACKGROUND A good number of primary open angle glaucoma patients present with advanced optic nerve head cupping. An understanding of the relationship between the structural and functional damage is important at this stage of glaucoma. We wanted to study the field defects in advanced optic nerve cupping in patients with Primary Open Angle Glaucoma (POAG) on treatment. METHODS 26 eyes of 19 Primary Open Angle Glaucoma (POAG) patients having optic nerve head cupping with Cup Disc Ratio (CDR) of 0.9 by slit lamp biomicroscopic examination, who were on treatment, attending Glaucoma Clinic in Government Medical College, Thrissur were evaluated. Patients with Narrow Angle Glaucoma and Secondary Glaucoma were excluded. They were subjected for 24-2 Protocol of Humphry Field Analyser. Grading of field defects was done according to HodappParrish-Anderson Glaucoma Grading Scale. The field defects of these patient were categorized under the headings of Early, Moderate, Advanced and Severe. Analysis of grading of field defects was then performed. RESULTS Males and females were in the ratio 1.1:1. Majority of the patients were in the age group 60-69 years. Severe field loss was seen in 46% of our study population. They were in the age group 60-69 years. Advanced field defects were seen in 35%. They were in the age group 50-59 years and 60-69 years. Even moderate field defects were in 15%. They were in the age group 50-59 years and 60-69 years. 4% showed early field defects. CONCLUSIONS With the same optic disc cupping, patients can have different grades of field defects. Even with advanced cupping, (CDR 0.9 and above), the field defects may not be always severe or worse. So, there is hope for visual function in these patients with proper treatment and follow up.
