Correlation of visual function with optic nerve and nerve fiber layer structure in glaucoma.

Careful clinical correlation of the appearance of the optic nerve and retinal nerve fiber layer with measurements of the visual field is an important aspect of the evaluation of patients with glaucoma. The anatomy of the nerve fiber layer and its retinotopic projections to the optic nerve head form the basis of the spatial relationships between structure and function in glaucoma. Clinical experience with the temporal correlations of structure and function indicates that visible alterations of the optic nerve and surrounding nerve fiber layer may occur before scotomas in the visual field can be detected. Quantitative clinical studies of the optic nerve and visual field support this concept, and provide additional clues regarding the pathogenesis of glaucomatous optic nerve damage.