Optic Cup (anatomical)
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The optic cup is the white, cup-like area in the center of the
optic disc The optic disc or optic nerve head is the point of exit for ganglion cell axons leaving the eye. Because there are no rods or cones overlying the optic disc, it corresponds to a small blind spot in each eye. The ganglion cell axons form the ...
. The ratio of the size of the optic cup to the optic disc (cup-to-disc ratio, or C/D) is one measure used in the diagnosis of
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
. Different C/Ds can be measured horizontally or vertically in the same patient. C/Ds vary widely in healthy individuals. However, larger vertical C/Ds, or C/Ds which are very different between the eyes, may raise suspicion of glaucoma. A C/D which enlarges vertically over months or years suggests glaucoma.


Cup-to-disc ratio

The ''cup-to-disc ratio'' (often notated ''CDR'') is a measurement used in
ophthalmology Ophthalmology ( ) is a surgical subspecialty within medicine that deals with the diagnosis and treatment of eye disorders. An ophthalmologist is a physician who undergoes subspecialty training in medical and surgical eye care. Following a medic ...
and
optometry Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive primary eye care. In the Uni ...
to assess the progression of
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
. The
optic disc The optic disc or optic nerve head is the point of exit for ganglion cell axons leaving the eye. Because there are no rods or cones overlying the optic disc, it corresponds to a small blind spot in each eye. The ganglion cell axons form the ...
is the anatomical location of the eye's "blind spot", the area where the optic nerve leave and blood vessels enter the retina. The optic disc can be flat or it can have a certain amount of normal cupping. But glaucoma, which is in most cases associated with an increase in
intraocular pressure Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated to ...
, often produces additional pathological cupping of the optic disc. The pink rim of disc contains nerve fibers. The white cup is a pit with no nerve fibers. As glaucoma advances, the cup enlarges until it occupies most of the disc area. The cup-to-disc ratio compares the diameter of the cup portion of the optic disc with the total diameter of the optic disc. A good analogy to better understand the cup-to-disc ratio is the ratio of a donut hole to a donut. The hole represents the cup and the surrounding area the disc. If the cup fills 1/10 of the disc, the ratio will be 0.1. If it fills 7/10 of the disc, the ratio is 0.7. The normal cup-to-disc ratio is less than 0.5. A large cup-to-disc ratio may imply glaucoma or other pathology. However, cupping by itself is not indicative of glaucoma. Rather, it is an increase in cupping as the patient ages that is an indicator for glaucoma. Deep but stable cupping can occur due to hereditary factors without glaucoma.


References

Eye Sensory organs Visual system Ophthalmology {{eye-stub