Disc Haemorrhages

The Science behind the Tip

Although described most commonly in normal tension glaucoma, optic disc haemorrhages may occur in all forms of glaucoma. In the absence of other associated disorders, their presence warns of an eye at risk of developing glaucoma or having progressive glaucomatous damage.

The risk is higher for older patients, more advanced glaucoma or recurrence of a haemorrhage in the same eye. The location correlates with any ensuing visual field or disc abnormalities.

Careful clinical examination using sufficient magnification and supplemented with optic disc photography, enhances the detection rate of disc haemorrhages. Affected patients should be followed up more frequently and need to have their intraocular pressure reduced further.

Contributor: H Shahid DM MA MRCOphth, Oxford Eye Hospital

References

1. Drance S, Anderson DR, Schulzer M CNTG study group. Risk factors for progression of visual field abnormalities in normal tension glaucoma. Am J Ophthalmol 2001; 131: 699-708

2. Leske MC, Heijl A, Hyman L. Predictors of long-term progression in the Early Manifest Glaucoma Trial. 2007; Ophthalmology 114: 1965-72

3. Siegner SW, Netland PA. Optic disc haemorrhages and progression of glaucoma. Ophthalmology 1996; 103:1014-1024

Tip Reviewer: Roger Hitchings
Tip Editors: Ann Hoste, John Salmon and John Thygesen