Fundus photography is a crucial tool for evaluating and documenting the condition of the optic nerve and retina. Unlike OCT scanning, which provides numerical and microscopic data, photography allows the doctor to obtain a clear, objective visual representation of the optic nerve head (the disc).
What do we look for in Fundus Photography?
In glaucoma, we examine the 'optic nerve head.' We focus on the size of the central depression (the cup) relative to the overall size of the nerve (the disc), and assess whether there is thinning of the neural rim (Neuroretinal rim). Photography also enables the detection of tiny hemorrhages on the disc (Drance hemorrhages), which are signs of active and progressing glaucoma, as well as the mapping of blood vessels and changes around the optic nerve (PPA).
Comparison Over Time
The primary importance of photography lies in the ability to compare the current appearance of the optic nerve to its past condition. Even subtle changes in the cup borders or the appearance of a new hemorrhage can suggest disease progression and guide treatment decisions, sometimes even before the damage is evident on a visual field test. Therefore, photographic documentation as a baseline is a necessary step in managing every glaucoma patient.