Five rules to evaluate the optic disc and retinal nerve fiber layer for glaucoma.

A systematic approach for the examination of the optic disc and retinal nerve fiber layer is described that will aid in the detection of glaucoma. This approach encompasses 5 rules: evaluation of optic disc size, neuroretinal rim size and shape, retinal nerve fiber layer, presence of parapapillary atrophy, and presence of retinal or optic disc hemorrhages. A systematic process enhances the ability to detect glaucomatous damage as well as the detection of progression, and facilitates appropriate management.