Ophthalmology

Optic Nerve Cupping

The optic nerve connects your eye to your brain and carries the signals that allow you to see. When your eye doctor looks inside your eye, they can see the optic nerve head—the spot where the nerve fibers exit the eye. The small depression in the center of that nerve is called the cup.

Some amount of cupping is normal, but when the cup becomes larger or changes over time, it can signal a problem such as glaucoma or another optic nerve condition. Not all cupping means glaucoma, and determining the cause requires expert evaluation.

At UI Health, our team combines glaucoma specialists, neuro-ophthalmologists, and neurologists—along with researchers developing new diagnostic technologies—to deliver the most advanced care available.

Comprehensive Evaluation

Because many eye and brain conditions can look similar to glaucoma, our doctors use a complete set of tests and tools to understand what’s happening with your optic nerve, including:

• Optical coherence tomography (OCT): Creates detailed images of your optic nerve fibers
• Visual field testing: Maps areas of vision loss to pinpoint where damage may be occurring
• Neuro-ophthalmic evaluation: Assesses how the eyes and brain work together
• Advanced imaging (MRI/CT): Used when there may be nerve compression or other neurologic causes

This thorough approach helps distinguish between glaucomatous cupping and other causes such as ischemic, hereditary, or compressive optic nerve damage.

Personalized Treatment and Surgical Expertise

If glaucoma is confirmed, our glaucoma specialists offer the full range of treatment options—from medications and laser therapy to advanced surgical procedures such as:

• Minimally invasive glaucoma surgery (MIGS)
• Trabeculectomy and drainage devices
• Combined cataract and glaucoma surgery

Our surgeons are leaders in caring for patients with normal-tension glaucoma and those with complex or previously failed surgeries. Because several of our experts are dual-trained in glaucoma and neuro-ophthalmology, every surgical plan takes both eye and brain factors into account for the best possible outcome.