• arcuate glaucoma...differential diagnosis
• cupped disc...differential diagnosis

If there is an arcuate scotoma there must be a notch. No notch, suspect not glaucoma. Here are the other causes of an arcuate scotomas.

• Prelaminar
  • optic disc drusen
  • papilloedema (eg BIH/IIH)
• laminar
  • ION..ischaemic optic neuropathy, +/- artereritic
• optic canal
  • infiltrative, meningioma, demyelination, inflammatory mass
• intracanalicular
  • carotid... ectatic or aneurysm

Generally an MRI will be helpful....contrast, fat suppression, T1.

This is well reviewed by Trobe.

• if there is a notch...87% chance glaucoma
• if the rim is pale.....90% NOT glaucoma

To assess

1. Vision reduced ...not glaucoma. In glaucoma..vision good until late
2. Colour vision reduced... not glaucoma. Test wish Ischiara or a simple red target.
3. RAPD  test...if there is a defect, glaucoma unlikely
4. pale disc...not glaucoma as above
5. symptoms..not glaucoma. Generally glaucoma is assymptomatic.
6. field and discs correspond...= glaucoma (as above)