Imaging of the optic disc in glaucoma: which way to go?

Less than 10 years ago, fundus photography was believed to be the only method to document optic disc changes in glaucoma. Since then, many sophisticated electronic devices have been developed to supersede conventional photography. At the moment, confocal laser scanning tomography, nerve fiber layer polarimetry, and optical coherence tomography are the most popular techniques. The current status of optic disc imaging in glaucoma can (in our very subjective opinion) be summarized as follows. Confocal laser scanning tomography is the most comprehensively tested electronic modality. It is perhaps the method of choice in major glaucoma centers. Nerve fiber layer polarimetry has forged ahead during the past 2 years and may become an alternative to confocal laser scanning tomography in the future. Optical coherence tomography is a fascinating technique, which may also become important in the future. Right now, however, it is still in the experimental stage. Conventional disc photography--despite all those new techniques--still has its place. Perhaps it is the method of choice in routine glaucoma practice, except those clinics that can afford one of the "high tech" machines.