Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy

Arch Ophthalmol. 1982 Jan;100(1):135-46. doi: 10.1001/archopht.1982.01030030137016.


The number and distribution of human optic nerve axons were compared with clinical measurements available the same eyes, including visual acuity, disc appearance, and visual field studies. Definite loss of axons occurs prior to reproducible visual field defects in some patients suspected of having glaucoma. In glaucoma, the superior and inferior poles of the nerve lose nerve fibers at a selectively greater rate, leading to an hourglass-shaped atrophy. Cavernous degeneration of the retrobulbar optic nerve is rarely observed in chronic glaucoma. The pattern of atrophy in examples of toxic amblyopia, ischemic optic neuropathy and chronic papilledema differ from that of glaucoma, suggesting different mechanisms of damage in these conditions.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Child, Preschool
  • Female
  • Glaucoma / complications*
  • Glaucoma / pathology
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Optic Atrophy / etiology*
  • Optic Atrophy / pathology
  • Optic Nerve / pathology
  • Optic Nerve Diseases / pathology
  • Papilledema / pathology
  • Vision Disorders / etiology
  • Vision Disorders / pathology
  • Visual Acuity
  • Visual Fields