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Jost B. Jonas, MD

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With interest I read the Photo Essay by Randhawa et al¹ on a megalopapilla, and I would like to congratulate the authors for it. As they point out, the large pseudoglaucomatous optic cup is easily explained by the large disc according to the correlation between disc size and cup size.² There are, however, additional morphological parameters that suggest normality of this pseudoglaucomatous optic nerve head. The most important of these parameters may be the inferior-superior-nasal-temporal rule of the physiologic shape of the neuroretinal rim, which is perfectly fulfilled: the rim is widest inferiorly, followed by the superior disc pole, and then the nasal disc region. It is smallest in the temporal disc region.³ In addition, the visibility of the retinal nerve fiber layer is age-related normal, with a slightly better visibility in the temporal inferior region compared with the temporal superior region and the nasal superior . . . [Full Text of this Article]

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RELATED ARTICLE

Megalopapilla, Not Glaucoma
Sandeep Randhawa, Vinay A. Shah, and Randy H. Kardon
Arch Ophthalmol. 2007;125(8):1134.
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RELATED LETTER

Large Optic Disc—Reply
Randy Kardon, Sandeep Randhawa, and Vinay Shah
Arch Ophthalmol. 2008;126(4):582.
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