pathogenesis of optic nerve damage in glaucoma

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The pathogenesis of optic nerve damage in glaucoma remains uncertain but two mechanisms which are thought to be responsible have been proposed (1,2)

  • mechanical theory - increased intra ocular pressure (IOP) results in posterior displacement of the lamina cribrosa causing damage to the retinal ganglion cells that pass through it
  • vascular theory - axonal death results from poor optic nerve head capillary perfusion. IOP is normal (2)

Much doubt exists regarding these two mechanisms and evidence suggests that glaucomatous changes may result from a complex interaction between these two (2).

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Last reviewed 06/2022