March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Clinical Detection of Optic Disc Hemorrhage
Author Affiliations & Notes
  • Melissa A. Knowles
    Ophthalmology, East Florida Eye Institute, Stuart, Florida
  • Ronald E. Frenkel
    Ophthalmology, East Florida Eye Institute, Stuart, Florida
    Bascom Palmer, Miami, Florida
  • Shahim Haji
    Ophthalmology, East Florida Eye Institute, Stuart, Florida
    Ophthalmology, University of Missouri, Kansas City, Missouri
  • Heather B. Seith
    Ophthalmology, East Florida Eye Institute, Stuart, Florida
  • M.P.C. Frenkel
    Ophthalmology, East Florida Eye Institute, Stuart, Florida
  • Footnotes
    Commercial Relationships  Melissa A. Knowles, None; Ronald E. Frenkel, None; Shahim Haji, None; Heather B. Seith, None; M.P.C. Frenkel, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 260. doi:
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    • Get Citation

      Melissa A. Knowles, Ronald E. Frenkel, Shahim Haji, Heather B. Seith, M.P.C. Frenkel; Clinical Detection of Optic Disc Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2012;53(14):260.

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      © ARVO (1962-2015); The Authors (2016-present)

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To determine what percentage of disc hemorrhages are discovered by examination of optic nerve photographs as opposed to clinical examination


A glaucoma clinical fellow (SH) reviewed single optic disc photos of 371 eyes of 188 patients with glaucoma who had been scheduled for routine optic nerve photographs. The fellow documented all detected disc hemorrhages. The fellow then reviewed charts of these patients for any disc hemorrhages that were documented on the date of the photograph. All clinical examinations were performed by a glaucoma specialist (RF) using indirect ophthalmoscopy through a dilated pupil utilizing either a 60D or 66D lens at the slit lamp.


4.3% of eyes had optic disc hemorrhages detected by review of disc photos. A total of 16 disc hemorrhages were detected by review of disc photos. Patients diagnosed with normal tension glaucoma had a 9.2% incidence of disc hemorrhage. Patients diagnosed with open angle glaucoma had a 1.6% incidence of disc hemorrhage. Each of the disc hemorrhages discovered by review of photographs had been previously detected and documented by clinical examination.


Our results demonstrate that a careful clinical examination using either a 60D or 66 D indirect lens at the slit lamp with a dilated pupil will reveal similar percentages of disc hemorrhage as photographic examination using a single photograph. This is important as disc photographs are not taken at each visit. Detection of disc hemorrhage is an important factor in the determination of progression of glaucoma. Optic disc hemorrhages (DH) are associated with worsening of glaucomatous optic neuropathy and visual field, and are the single strongest predictor of progression. Careful and systematic examination of the optic disc is critical to following glaucomatous progression.

Keywords: anatomy • optic disc 

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