Aims-To determine the age related changes in optic nerve head structure in a group of normal subjects and assess the significance of any changes in relation to those found in open angle glaucoma. Methods-A group of 88 white volunteers and friends and spouses of patients with a normal visual field and normal intraocular pressure was studied. Two diVerent imaging and measurement devices were used (computer assisted planimetry and scanning laser ophthalmoscopy), and the results from each were compared. Measurements were made of the optic disc, optic cup, and neuroretinal rim areas, and the vertical optic disc diameter and cup/disc diameter ratio. Results-Neuroretinal rim area declined at the rate of between 0.28% and 0.39% per year. Vertical optic cup diameter and optic cup area increased with age. The mean cup/disc diameter ratio increased by about 0.1 between the ages of 30 and 70 years. Conclusions-Age related changes are significant and measurable, and should be taken into account when assessing the glaucoma suspect, and when estimating the rate of progression of glaucomatous optic neuropathy in patients with established disease. (Br J Ophthalmol 1997;81:840-845) Open angle glaucoma (OAG) is a progressive, irreversible, optic neuropathy, for which the major risk factors are raised intraocular pressure and older age. Visual field loss is associated with the increase in optic cup size and other structural changes that occur at the optic nerve head. It is a common condition, the incidence of which increases with age. Prevalence varies with ethnic origin and estimates have been calculated in a recent review of the literature.

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Abstract. The authors illustrate the spectrum of Gauchers disease involving the eye in the case of a 51year-old man suffering from Type I Gauchers disease who presented with unusual macular changes. This is the first report of chronic adult non-neuronopathic disease (Type I) with a plaque-like mass at the fovea. Our hypothesis is that the lesion at the fovea is probably an aggregation of Gauchers cells. [Ophthalmic Surg Lasers 2000;31:331-333]