image of optic nerve. Large cupping, with peripheral thinnin | Figure 1

image of optic nerve. Large cupping, with peripheral thinning. Pressures normal. No family Hx of glaucoma. Any ideas on the diagnosis?

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  1. Name the finding in the fundus photo 2. Comment on the disk. 3. What's your diagnosis? Our answers posted on 18th or so.](https://app.figure1.com/case-detail/11c13091-3818-4aeb-99a1-c3f9ff354575)



OD nerve not obeying ISNT rule](https://app.figure1.com/case-detail/2472e8ee-db15-44f3-b2c7-3d34075b6795)



Interesting case of a 65YO WF who presented with a history of macular hole after 2 surgical attempts at a repair OD 2 years prior. Pt is also s/p PCIOL OD. Last eye exam 1 year prior. During exam, IOP was measured at 36mmHg OD, 14 mmHg OS. Pt denied any pain or discomfort. Visual fields were grossly full by confrontation. #Gonioscopy revealed open angles with iris processes noted in both eyes. OCT RNFL and fundoscopy revealed extensive optic nerve rim tissue thinning and cupping. Any differentials for why the IOP is so asymmetric? IOP OD dropped to 15 with Combigan bid OD.](https://app.figure1.com/case-detail/40ce5a47-952a-4b78-92a3-d5d5d755e19b)



Disregard cursor - so dumb I didn't move it. Drance heme indicating progression of glaucoma.](https://app.figure1.com/case-detail/525fd96d-db23-4634-85be-dd0ec3e3e5c8)

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