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The Optic Nerve in Glaucoma
This is the first comprehensive compilation of information specifically directed toward analyzing the optic nerve in diagnosis and management of glaucoma. The editors and contributors are leading international experts in the field. They analyze glaucoma as a pressure-related optic neuropathy, discussing the anatomy, embryology and pathophysiology of the optic nerve and how they relate to glaucoma.
Hardcover
First published January 1, 1992
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Displaying 1 - 1 of 1 review
September 12, 2026
4 ⭐️ A good book to start with if you are interested in learning more about glaucoma.
What to Expect
➜ Varma and Spaeth’s glaucoma textbook is easy to read and understand. It begins with basic optic nerve histology and physiology, then explains how glaucoma develops, looks and is evaluated, before concluding with treatment and management philosophies.
Likes
➜ To be an expert in glaucoma, you need to be an expert in evaluating the nerve. I found the chapter Development of Glaucomatous Changes of the Optic Nerve useful because it laid out everything to look for when you are suspicious of glaucoma. Varma and Spaeth write that there is no "first sign" and no single pattern to glaucoma, but they give you a framework in which to approach disc damage.
➜ This book also talks about what is NOT glaucoma (tilted discs and other optic atrophy). This was helpful to distinguish between "glaucoma suspects" vs normal tension glaucoma.
➜ Finally, the authors remind us that the most important thing is not whether the patient has glaucoma, but whether it is stable or progressing; and, if their glaucoma will interfere with the patients function. Those of us who treat glaucoma can get caught up in trying diagnose pre-parametric glaucoma or aggressively treating mild glaucoma, when in reality treatment may do more harm than good for patients that will never have any symptoms from their glaucoma to begin with.
Dislikes
➜ My main dislike is that there is just outdated information in this textbook. I skimmed a couple chapters on different techniques or instruments to look at the optic nerve that are no longer used.
➜ The authors also talk about “pallor” being part of your optic nerve evaluation, and how the optic nerve gets paler when there is more cupping… To be clear, glaucoma causes excavation of the neuro-retinal rim tissue, but there won’t be true whitening of the neuro-retinal rim that is greater than the cupping. The rim tissue and the visual field should correlate. If you are worried there is true pallor or a visual field defect that doesn’t align with the amount of rim excavation, I would consider non-glaucomatous optic atrophy.
Final Thoughts
➜ Glaucoma is complicated. I think reading this book is useful in helping doctors define their glaucoma treatment and management philosophies.
Read: August 2026
What to Expect
➜ Varma and Spaeth’s glaucoma textbook is easy to read and understand. It begins with basic optic nerve histology and physiology, then explains how glaucoma develops, looks and is evaluated, before concluding with treatment and management philosophies.
Likes
➜ To be an expert in glaucoma, you need to be an expert in evaluating the nerve. I found the chapter Development of Glaucomatous Changes of the Optic Nerve useful because it laid out everything to look for when you are suspicious of glaucoma. Varma and Spaeth write that there is no "first sign" and no single pattern to glaucoma, but they give you a framework in which to approach disc damage.
➜ This book also talks about what is NOT glaucoma (tilted discs and other optic atrophy). This was helpful to distinguish between "glaucoma suspects" vs normal tension glaucoma.
➜ Finally, the authors remind us that the most important thing is not whether the patient has glaucoma, but whether it is stable or progressing; and, if their glaucoma will interfere with the patients function. Those of us who treat glaucoma can get caught up in trying diagnose pre-parametric glaucoma or aggressively treating mild glaucoma, when in reality treatment may do more harm than good for patients that will never have any symptoms from their glaucoma to begin with.
Dislikes
➜ My main dislike is that there is just outdated information in this textbook. I skimmed a couple chapters on different techniques or instruments to look at the optic nerve that are no longer used.
➜ The authors also talk about “pallor” being part of your optic nerve evaluation, and how the optic nerve gets paler when there is more cupping… To be clear, glaucoma causes excavation of the neuro-retinal rim tissue, but there won’t be true whitening of the neuro-retinal rim that is greater than the cupping. The rim tissue and the visual field should correlate. If you are worried there is true pallor or a visual field defect that doesn’t align with the amount of rim excavation, I would consider non-glaucomatous optic atrophy.
Final Thoughts
➜ Glaucoma is complicated. I think reading this book is useful in helping doctors define their glaucoma treatment and management philosophies.
Read: August 2026
Displaying 1 - 1 of 1 review