The neuroretinal rim areas of 123 eyes (from five normal subjects, 75 patients with ocular hypertension, and 43 patients with glaucoma) were measured to determine the rate and pattern of rim area change during 5 to 15 years (mean, 10 years) of follow-up. Fifty-seven percent of the patients with ocular hypertension and 79% of those with glaucoma showed a statistically significant slope of rim area decrease, a high rate of loss being associated with a high initial rim area. Ninety percent of the variation of rim area loss was accounted for by variables other than the ones measured herein, however (age, disc area, initial rim area, and intraocular pressure). The yearly loss of rim area was 0.23% of the initial area in normal subjects, 0.47% and 2.75% in the patients with stable and deteriorating ocular hypertension, respectively, and 3.47% in the patients with deteriorating glaucoma. The pattern of rim area change was linear in 49% of the patients with a statistically significant rim area decrease, episodic in 22%, and curvilinear in 29%.