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Glaucoma (cupping)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The first sign of disc damage is usually an upper or lower temporal notch, giving rise to a nasal arcuate scotoma.

The extent of cupping is commonly assessed as the vertical cup:disc ratio, expressed as a fraction.

Characteristically, there is:

  • right/left asymmetry
  • cup to disc ratio is usually 0.5 or greater in the vertical plane
  • affected area of disc is atrophic - light grey / white rather than pink
  • the vessels may be angulated or kinked as they come over the rim of the cup - bayonetting
  • vessels shifted to nasal edge of disc
  • splinter haemorrhages at disc edge

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