Morphologic changes in the lamina cribrosa correlated with neural loss in open-angle glaucoma

Harry A. Quigley, Rebecca M. Hohman, Earl M. Addicks, Robert W. Massof, W. Richard Green

Research output: Contribution to journalArticlepeer-review

515 Scopus citations


We divided 25 glaucomatous human eyes into three groups representing mild (Group 1, seven eyes), moderate (Group 2, 11 eyes), and severe (Group 3, six eyes) optic nerve damage, based on visual field testing or remaining number of optic nerve fibers. The optic nerve head of each eye was examined by scanning electron microscopy. Compression of the successive lamina cribrosa sheets was the earliest detected abnormality, occurring in some eyes before the detection of visual field loss. Backward bowing of the entire lamina cribrosa was a later change and involved its upper and lower poles more than the mid-nerve head. The diameter of the scleral opening at the level of Bruch's membrane did not enlarge in these adult glaucomatous eyes. Mechanical compression of the nerve head occurred early enough to be considered a primary pathogenetic event in glaucomatous damage.

Original languageEnglish (US)
Pages (from-to)673-691
Number of pages19
JournalAmerican journal of ophthalmology
Issue number5
StatePublished - May 1983

ASJC Scopus subject areas

  • Ophthalmology


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