- Retina Nerve Fiber Layer (RNFL) defects are typically best documented and quantified with GDx and OCT.
- Focal RNFL defects are often detectable with panoramic ophthalmoscopy many disc diameters away from the optic nerve head.
- Such distant RNFL defects may or may not reach the disc but are real nevertheless as documented by corresponding GDx, OCT and visual fields abnormalities.
- RNFL defects that do not reach the disc do not result in observable disc changes.
- Many of the panoramic images to follow support and explain the existence and concept of “glaucoma without cupping.”1