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).
Reference:
- 1. Liesegang TJ. Glaucoma: changing concepts and future directions. Mayo Clin Proc. 1996;71(7):689-94
- 2. Kotecha A, Spratt A. Profiling glaucoma. Optometry today 2009.
Last reviewed 06/2022