Skip to main content
SpringerLink
Log in
Book cover

The Optic Nerve Head in Health and Disease pp 67–100Cite as

How to Reduce Error in Optic Nerve Head Examination

  • Chapter
  • First Online:

  • 289 Accesses

Abstract

Diagnosis of glaucoma requires more than the optic nerve head (ONH) evaluation findings alone, but ONH assessment is crucial to detection of glaucoma, assessment of severity, and monitoring for disease progression. Objective assessment of the ONH must be done independent of other clinical features. This chapter explores the process of examining the disc for glaucoma, where errors may occur, and strategies to avoid them.

This is the end. How did we get here?

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Quigley HA. Glaucoma. Lancet. 2011;377:1367–77.

    Article  PubMed  Google Scholar 

  2. Weinreb RN, Leung CK, Crowston JG, et al. Primary open-angle glaucoma. Nat Rev Dis Primers. 2016;2:16067.

    Article  PubMed  Google Scholar 

  3. Flaxman SR, Bourne RRA, Resnikoff S, et al. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. Lancet. 2017;5(12):E1221–34.

    Google Scholar 

  4. Leske MC. Open-angle glaucoma—an epidemiologic overview. Ophthalmic Epidemiol. 2007;14(4):166–72.

    Article  PubMed  Google Scholar 

  5. Walland MJ. On the lookout: how to save the sight of Australians who have glaucoma. Med J Aust. 2008;188:269–70.

    Article  PubMed  Google Scholar 

  6. Sommer A, Pollack I, Maumenee AE. Optic disc parameters and onset of glaucomatous field loss. I. Methods and progressive changes in disc morphology. Arch Ophthalmol. 1979;97:1444–8.

    Article  CAS  PubMed  Google Scholar 

  7. Pederson JE, Anderson DR. The mode of progressive disc cupping in ocular hypertension and glaucoma. Arch Ophthalmol. 1980;98:490–5.

    Article  CAS  PubMed  Google Scholar 

  8. Quigley HA, Addicks EM, Green WR. 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;100:135–46.

    Article  CAS  PubMed  Google Scholar 

  9. Sommer A, Katz J, Quigley HA, et al. Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss. Arch Ophthalmol. 1991;109:77–83.

    Article  CAS  PubMed  Google Scholar 

  10. Quigley HA, Katz J, Derick RJ, et al. An evaluation of optic disc and nerve fiber layer examinations in monitoring progression of early glaucoma damage. Ophthalmology. 1992;99:19–28.

    Article  CAS  PubMed  Google Scholar 

  11. Airaksinen PJ, Tuulonen A, Alanko HI. Rate and pattern of neuroretinal rim area decrease in ocular hypertension and glaucoma. Arch Ophthalmol. 1992;110:206–10.

    Article  CAS  PubMed  Google Scholar 

  12. Gordon MO, Beiser JA, Brandt JD, et al. The ocular hypertension treatment study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120(6):714–20.

    Article  PubMed  Google Scholar 

  13. Tielsch JM, Katz J, Sommer A, et al. Family history and risk of primary open angle glaucoma. The Baltimore eye survey. Arch Ophthalmol. 1994;112:69–73.

    Article  CAS  PubMed  Google Scholar 

  14. Johnson CA, Sample PA, Zangwill LM, et al. Structure and function evaluation (SAFE): II. Comparison of optic disk and visual field characteristics. Am J Ophthalmol. 2003;135:148–54.

    Article  PubMed  Google Scholar 

  15. Michelessi M, Lucenteforte E, Oddone F, et al. Optic nerve head and fibre layer imaging for diagnosing glaucoma. Cochrane Database Syst. 2015;11:CD008803.

    Google Scholar 

  16. Kong YX, Coote MA, O’Neill EC, et al. Glaucomatous optic neuropathy evaluation project: a standardized internet system for assessing skills in optic disc examination. Clin Exp Ophthalmol. 2011;39:308–17.

    Article  PubMed  Google Scholar 

  17. O’Neill EC, Kong YX, Connell PP, et al. Gaze behavior among experts and trainees during optic disc examination: does how we look affect what we see? Invest Ophthalmol Vis Sci. 2011;52:3976–83.

    Article  PubMed  Google Scholar 

  18. O'Neill EC, Gurria LU, Pandav SS, et al. Glaucomatous optic neuropathy evaluation project: factors associated with underestimation of glaucoma likelihood. JAMA Ophthalmol. 2014;132:560–6.

    Article  PubMed  Google Scholar 

  19. Kong YXG, Crowston JG, Coote M, et al. Understanding glaucoma optic nerve assessment through systemic observation: the GONE project. SAOJ. 2016;11(4):20–5.

    Google Scholar 

  20. Gaasterland DE, Blackwell B, Dally LG, et al. The advanced glaucoma intervention study (AGIS): 10. Variability mong academic glaucoma subspecialists in assessing optic disc notching. Tr Am Ophth Soc. 2001;99:177–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Abrams LS, Scott IU, Spaeth GL, et al. Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma. Ophthalmology. 1994;101(10):1662–7.

    Article  CAS  PubMed  Google Scholar 

  22. Hadwin SE, Redmond T, Garway-Heath DF, et al. Assessment of optic disc photographs for glaucoma by UK optometrists: the Moorfields optic disc assessment study (MODAS). Ophthalmic Physiol Opt. 2013;33:618–24.

    Article  PubMed  Google Scholar 

  23. Reus NJ, Lemij HG, EODAT group. Characteristics of misclassified discs in the European optic disc assessment trial (EODAT) [abstract from ARVO annual meeting]. Invest Ophthalmol Vis Sci. 2008;49:3627.

    Google Scholar 

  24. Varma R, Steinmann WC, Scott IU. Expert agreement in evaluating the optic disc for glaucoma. Ophthalmology. 1992;99:215.

    Article  CAS  PubMed  Google Scholar 

  25. Lichter PR. Variability of expert observers in evaluating the optic disc. Trans Am Ophthalmol Soc. 1976;74:532–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Harper R, Reeves B, Smith G. Observer variability in optic disc assessment: implications for glaucoma shared care. Ophthalmic Physiol Opt. 2000;20(4):265–73.

    Article  CAS  PubMed  Google Scholar 

  27. Nicolela MT, Drance SM, Broadway DC, et al. Agreement among clinicians in the recognition of patterns of optic disk damage in glaucoma. Am J Ophthalmol. 2001;132(6):836–44.

    Article  CAS  PubMed  Google Scholar 

  28. Reus NJ, de Graaf M, Lemij HG. Accuracy of GDx VCC, HRT I, and clinical assessment of stereoscopic optic nerve head photographs for diagnosing glaucoma. Br J Ophthalmol. 2007;91(3):313–8.

    Article  PubMed  Google Scholar 

  29. Reus NJ, Lemij HG, Garway-Heath DF, et al. Clinical assessment of stereoscopic optic disc photographs for glaucoma: the European optic disc assessment trial. Ophthalmology. 2010;117(4):717–23.

    Article  PubMed  Google Scholar 

  30. DeLeon-Ortega JE, Arthur SN, McGwin G, et al. Discrimination between glaucomatous and nonglaucomatous eyes using quantitative imaging devices and subjective optic nerve head assessment. Invest Ophthalmol Vis Sci. 2006;47(8):3374–80.

    Article  PubMed  Google Scholar 

  31. Taylor HR. Eye care for the future: the Weisenfeld lecture. Invest Ophthalmol Vis Sci. 2003;44(4):1413–8.

    Article  PubMed  Google Scholar 

  32. Mitchell P, Smith W, Attebo K, et al. Prevalence of open-angle glaucoma in Australia. The blue mountains eye study. Ophthalmology. 1996;103(10):1661–9.

    Article  CAS  PubMed  Google Scholar 

  33. Sommer A, Tielsch JM, Katz J, et al. Relationship between intraocular pressure and primary open angle glaucoma among white and black Americans: the Baltimore eye survey. JAMA Ophthalmol. 1991;109(8):1090–5.

    CAS  Google Scholar 

  34. Cedrone C, Mancino R, Cerulli A, et al. Epidemiology of primary glaucoma: prevalence, incidence, and blinding effects. Prog Brain Res. 2008;173:3–14.

    Article  PubMed  Google Scholar 

  35. Wensor MD, McCarty CA, Stanislaosky YL, et al. The prevalence of glaucoma in the Melbourne visual impairment project. Ophthalmology. 1998;105:733–9.

    Article  CAS  PubMed  Google Scholar 

  36. Keeffe JE, Weih LM, McCarty CA, et al. Utilisation of eye care services by urban and rural Australians. Br J Ophthalmol. 2002;86:24–7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Wong EY, Keeffe JE, Rait JL, et al. Detection of undiagnosed glaucoma by eye health professionals. Ophthalmology. 2004;111:1508–14.

    Article  PubMed  Google Scholar 

  38. Van der Shoot J, Reus NJ, Garway-Heath D, et al. Accuracy of matching optic discs with visual fields: the European structure and function assessment trial (ESAFAT). Ophthalmology. 2013;120(12):2470–5.

    Article  Google Scholar 

  39. Chauhan BC, Hutchison DM, Artes PH, et al. Optic disc progression in glaucoma: comparison of confocal scanning laser tomography to optic disc photographs in a prospective study. Invest Ophthalmol Vis Sci. 2009;50(4):1682–91.

    Article  PubMed  Google Scholar 

  40. Wilsey LJ, Fortune B. Electroretinography in glaucoma diagnosis. Curr Opin Ophthalmol. 2016;27(2):118–24.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Jonas JB, Gusek GC, Naumann GO. Optic disc, cup and neuroretinal rim size, configuration and correlations in normal eyes. Invest Ophthalmol Vis Sci. 1988;29:1151–8.

    CAS  PubMed  Google Scholar 

  42. Jonas JB, Budde WM, Panda-Jonas S. Ophthalmoscopic evaluation of the optic nerve head. Surv Ophthalmol. 1999;43:293–320.

    Article  CAS  PubMed  Google Scholar 

  43. Jonas JB, Budde WM. Diagnosis and pathogenesis of glaucomatous optic neuropathy: morphological aspects. Prog Retin Eye Res. 2000;19(1):1–40.

    Article  CAS  PubMed  Google Scholar 

  44. Sanfilippo PG, Cardini A, Hewitt AW, et al. Optic disc morphology -- rethinking shape. Prog Retin Eye Res. 2009;28:227–48.

    Article  PubMed  Google Scholar 

  45. Burgoyne C. The morphological differences between glaucoma and other optic neuropathies. J Neuroophthalmol. 2015;35:S8–S21.

    Article  PubMed  PubMed Central  Google Scholar 

  46. O'Neill EC, Danesh-Meyer HV, Kong GX, et al. Optic disc evaluation in optic neuropathies: the optic disc assessment project. Ophthalmology. 2011;118:964–70.

    Article  PubMed  Google Scholar 

  47. Hewitt AW, Poulsen JP, Alward AL, et al. Heritable features of the optic disc: a novel twin method for determining genetic significance. Invest Ophthalmol Vis Sci. 2007;48(6):2469–75.

    Article  PubMed  Google Scholar 

  48. Healey PR, Carbonaro F, Taylor B, et al. The heritability of optic disc parameters: a classic twin study. Invest Ophthalmol Vis Sci. 2008;49(1):77–80.

    Article  PubMed  Google Scholar 

  49. Garway-Heath DF, Wollstein G, Hitchings RA. Aging changes of the optic nerve head in relation to open angle glaucoma. Br J Ophthalmol. 1997;81:840–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Vianna JR, Danthurebandara VM, Sharpe GP, et al. Importance of normal aging in estimating the rate of glaucomatous neuroretinal rim and retinal nerve fiber layer loss. Ophthalmology. 2015;122(12):2392–8.

    Article  PubMed  Google Scholar 

  51. Crowston JG, Hopley CR, Healey PR, et al. The effect of optic disc diameter on vertical cup to disc ratio percentiles in a population based cohort: the blue mountains eye study. Br J Ophthalmol. 2004;88:766–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Baniasadi N, Paschalis EI, Haghzadeh M. Patterns of retinal nerve fiber layer loss in different subtypes of open angle glaucoma using spectral domain optical coherence tomography. J Glaucoma. 2016;25(10):865–72.

    Article  PubMed  Google Scholar 

  53. Spaeth GL. A new classification of glaucoma including focal glaucoma. Surv Ophthalmol. 1994;38:S9–S17.

    Article  PubMed  Google Scholar 

  54. Nicolela MT, Drance SM. Various glaucomatous optic nerve appearances: clinical correlations. Ophthalmology. 1996;103(4):640–9.

    Article  CAS  PubMed  Google Scholar 

  55. Sng CC, See JS, Ngo CS, et al. Changes in retinal nerve fibre layer, optic nerve head morphology, and visual field after acute primary angle closure. Eye. 2011;25(5):619–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Ericsson A, Pool R. Peak: how all of us can achieve extraordinary things. Random House; 2016.

    Google Scholar 

  57. Coote MA, Crowston JG. Optic nerve head clinical examination. In: Basic course in glaucoma. World Glaucoma Association; 2017. Retrieved from https://wga.one/wga/basic-course-in-glaucoma/

  58. Kirwan JF, Gouws P, Linnell AE, et al. Pharmacological mydriasis and optic disc examination. Br J Ophthalmol. 2000;84:894–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Parkin B, Shuttleworth G, Costen M, et al. A comparison of stereoscopic and monoscopic evaluation of optic disc topography using a digital optic disc stereo camera. Br J Ophthalmol. 2001;85(11):1347–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Morgan JE, Sheen NJ, North RV, et al. Digital imaging of the optic nerve head: monoscopic and stereoscopic analysis. Br J Ophthalmol. 2005;89(7):879–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Chan HH, Ong DN, Kong YX, et al. Glaucomatous optic neuropathy evaluation (GONE) project: the effect of monoscopic versus stereoscopic viewing conditions on optic nerve evaluation. Am J Ophthalmol. 2014;157:936–44.

    Article  PubMed  Google Scholar 

  62. Garway-Heath DF, Ruben ST, Viswanathan A, et al. Vertical cup/disc ratio in relation to optic disc size: its value in the assessment of the glaucoma suspect. Br J Ophthalmol. 1998;82:1118–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Sheen NJ, Morgan JE, Poulsen JL, et al. Digital stereoscopic analysis of the optic disc: evaluation of a teaching program. Ophthalmology. 2004;111(10):1873–9.

    PubMed  Google Scholar 

  64. Scheetz J, Koklanis K, McGuinness M, et al. A randomized trial to increase the assessment accuracy of glaucoma and optic disc characteristics by orthoptists. J Contin Educ Health. 2019;39(3):161–7.

    Article  Google Scholar 

  65. Jonas JB, Fernandez MC, Naumann GO. Glaucomatous parapapillary atrophy. Occurrence and correlations. Arch Ophthalmol. 1992;110:214–22.

    Article  CAS  PubMed  Google Scholar 

  66. Jonas JB. Clinical implications of peripapillary atrophy in glaucoma. Curr Opin Ophthalmol. 2005;16(2):84–8.

    Article  PubMed  Google Scholar 

  67. Teng CC, CG DM, Prata TS, et al. β-zone parapapillary atrophy and the velocity of glaucoma progression. Ophthalmology. 2010;117(5):909–15.

    Article  PubMed  Google Scholar 

  68. Hoffman EM, Zangwill LM, Crowston JG, et al. Optic disc size and glaucoma. Surv Ophthalmol. 2007;52(1):32–49.

    Article  Google Scholar 

  69. Jonas JB, Zach FM, Gusek GC, et al. Pseudoglaucomatous physiologic large cups. Am J Ophthalmol. 1989;107:137–44.

    Article  CAS  PubMed  Google Scholar 

  70. Girkin CA, McGwin G Jr, Long C, et al. Subjective and objective optic nerve assessment in African Americans and whites. Invest Ophthalmol Vis Sci. 2004;45(7):2272–8.

    Article  PubMed  Google Scholar 

  71. Wang Y, Xu L, Zhang L, et al. Optic disc size in a population based study in northern China: the Beijing eye study. Br J Ophthalmol. 2006;90:353–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Jonas JB, Kling F, Grundler AE. Optic disc shape, corneal astigmatism, and amblyopia. Ophthalmology. 1997;104(11):1934–7.

    Article  CAS  PubMed  Google Scholar 

  73. Yang H, Ren R, Lockwood H, et al. The connective tissue components of optic nerve head cupping in monkey experimental glaucoma part 1: global change. Invest Ophthalmol Vis Sci. 2015;56(13):7661–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Azuara-Blanco A, Harris A, Cantor LB, et al. Effects of short term increase of intraocular pressure on optic disc cupping. Br J Ophthalmol. 1998;82:880–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Harizman N, Oliveira C, Chiang A, et al. The ISNT rule and differentiation of normal from glaucomatous eyes. Arch Ophthalmol. 2006;124:1579–83.

    Article  PubMed  Google Scholar 

  76. Chan EW, Liao J, Wong R, et al. Diagnostic performance of the ISNT rule for glaucoma based on the Heidelberg retinal tomograph. Trans Vis Sci Tech. 2013;2(5):2.

    Article  Google Scholar 

  77. Poon LY, Sola-Del Valle D, Turalba AV, et al. The ISNT rule: how often does it apply to disc photographs and retinal nerve fibre layer measurements in the normal population? Am J Ophthalmol. 2017;184:19–27.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Jung KI, Jung Y, Park KT, et al. Factors affecting plastic lamina cribrosa displacement in glaucoma patients. Invest Ophthalmol Vis Sci. 2014;55(12):7709–15.

    Article  PubMed  Google Scholar 

  79. Drance SM, Fairclough M, Butler DM. The importance of disc hemorrhage in the prognosis of chronic open angle glaucoma. Arch Ophthalmol. 1977;95(2):226–8.

    Article  CAS  PubMed  Google Scholar 

  80. Healey PR, Mitchell P, Smith W, et al. Optic disc hemorrhages in a population with and without signs of glaucoma. Ophthalmology. 1998;105(2):216–23.

    Article  CAS  PubMed  Google Scholar 

  81. Budenz DL, Anderson DR, Feuer WJ, et al. Detection and prognostic significance of optic disc hemorrhages from during the ocular hypertension treatment study. Ophthalmology. 2006;113(12):2137–43.

    Article  PubMed  Google Scholar 

  82. Leske MC, Heijl A, Hyman L, et al. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007;114(11):1965–72.

    Article  PubMed  Google Scholar 

  83. De Moraes CG, Prata TS, Liebmann CA, et al. Spatially consistent, localized visual field loss before and after disc hemorrhage. Invest Ophthalmol Vis Sci. 2009;50(10):4727–33.

    Article  PubMed  Google Scholar 

  84. Budenz DL, Huecker JB, Gedde SJ, et al. Thirteen-year follow-up of optic disc hemorrhages in the ocular hypertension treatment study. Am J Ophthalmol. 2017;174:126–33.

    Article  PubMed  Google Scholar 

  85. Parikh RS. Normal age-related decay of retinal nerve fiber layer thickness. Ophthalmology. 2007;114(5):921–6.

    Article  PubMed  Google Scholar 

  86. Dias DT, Ushida M, Battistella R, et al. Neurophthalmological conditions mimicking glaucomatous optic neuropathy: analysis of the most common causes of misdiagnosis. BMC Ophthalmol. 2017;17:2.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Fraser CL, White AJ, Plant GT, et al. Optic nerve cupping and the neuro-ophthalmologist. J Neuroophthalmol. 2013;33(4):377–89.

    PubMed  Google Scholar 

  88. Feldman RM, Cioffi GA, Liebmann JM, et al. Current knowledge and attitudes concerning cost-effectiveness in glaucoma pharmacotherapy: a glaucoma specialists focus group study. Clin Ophthalmol. 2020;14:729–39.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Chan CC, Crowston JG, Tan R, et al. Burden of ocular surface disease in patients with glaucoma from Australia. Asia Pac J Ophthalmol. 2013;2(2):79–87.

    Article  Google Scholar 

  90. Palmer E, Gale J, Crowston JG, et al. Optic nerve head drusen: an update. Neuroophthalmology. 2018;42(6):367–84.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Noval S, Visa J, Conteras I. Visual field defects due to optic nerve head drusen in children. Graefes Arch Clin Exp Ophthalmol. 2013;251(10):2445–50.

    Article  PubMed  Google Scholar 

  92. Yin X, Li J, Zhang B, et al. Association of glaucoma with risk of retinal vein occlusion: a meta-analysis. Acta Ophthalmol. 2019;97(7):652–9.

    Article  PubMed  Google Scholar 

  93. Hitchings RA, Spaeth GL. The optic disc in glaucoma. Br J Ophthalmol. 1976;60:778–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Centre for Eye Research Australia, East Melbourne, VIC, Australia

    Craig Ross, George Kong & Michael A. Coote

  2. University of Melbourne, Parkville, VIC, Australia

    George Kong

  3. Royal Victorian Eye and Ear Hospital, Melbourne, East Melbourne, VIC, Australia

    George Kong & Michael A. Coote

  4. Director, Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia

    Keith R. Martin

  5. University of Melbourne and Latrobe University, Melbourne, Australia

    Michael A. Coote

Authors
  1. Craig Ross
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. George Kong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keith R. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael A. Coote
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Advanced Eye Centre, Post Graduate Institute of Medical Education, Chandigarh, India

    Surinder Pandav

  2. Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India

    Parul Ichhpujani

  3. University of Melbourne and Latrobe University, Melbourne, Australia

    Michael A. Coote

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ross, C., Kong, G., Martin, K.R., Coote, M.A. (2021). How to Reduce Error in Optic Nerve Head Examination. In: Pandav, S., Ichhpujani, P., Coote, M.A. (eds) The Optic Nerve Head in Health and Disease. Springer, Singapore. https://doi.org/10.1007/978-981-33-6838-5_5

Download citation

  • DOI: https://doi.org/10.1007/978-981-33-6838-5_5

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-33-6837-8

  • Online ISBN: 978-981-33-6838-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation