IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 2 Ser.8 (February. 2020), PP 53-59 www.iosrjournals.org DOI: 10.9790/0853-1902085359 www.iosrjournals.org 53 | Page Correlation of optic nerve head changes in glaucoma patients with asymmetric pupillary light reflex, VEP and visual functions Praveena Kher 1 , Nupur Gupta 2 , Pravin Tidake 3 , Vrushali Shende 4 1 (Department of ophthalmology, JNMC, Sawangi, India) 2 (Department of ophthalmology, JNMC, Sawangi, India) 3 (Department of ophthalmology, JNMC, Sawangi, India) 4 (Department of ophthalmology, JNMC, Sawangi, India) Abstract: Background: Glaucoma is defined as a group of eye disease with multifactorial etiology, characterized by an acquired loss of retinal ganglion cells, progressive optic neuropathy with morphological abnormalities in the optic nerve head and, visual field defects, in which raised intraocular pressure(IOP) is modified risk factor. As glaucoma is a silent disease without much signs and symptoms, it is hard to diagnose the condition, especially in developing countries like India. Assessment of visual field defects is made by Perimetry. Asymmetric damage between eyes with glaucoma often results in creating relative afferent pupillary defect (RAPD). Colour vision assessment is done as red-green defects accompanied glaucomatous optic neuropathy. Due to raised IOP retinal nerve fibrebundle entering the optic nerve gets damaged leading to altered Visual evoked potential(VEP) waveforms. Materials and Methods: In this case-control observational study, 100 eyes of 100 patients were included. 50 eyes of 50 patients of primary open angle glaucoma and 50 eyes of 50 patients of control cases were enrolled. Results: The comparison of glaucoma staging system with optic disc changes, asymmetri pupillary light reflex, color vision defect and VEP were found to be clinically significant. Conclusion: Since glaucoma is considered to be second most common cause of blindness in India but having an major advantage of being preventable by early diagnosis and prompt treatment, early diagnostic tools like RAPD, colour vision and VEP have proved to be assistive tool to perimetry and optic nerve head changes in primary open angle glaucoma. Key Word: primary open angle glaucoma; RAPD; VEP; colour vision; perimetry. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 30-01-2020 Date of Acceptance: 15-02-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Open angle glaucoma is referred to as “silent killer of sight” due to its progress without causing any obvious symptoms – or really any symptoms at all. Glaucoma is fast emerging as major cause of blindness in India second only to cataract.(1) According to WHO it is the second most common cause of blindness in the world after cataract.(2) Approximately 60.5 million people were having glaucoma in the year 2010 in the world.(3)Glaucoma is defined as a group of eye diseases with multifactorial etiology, characterized by an acquired loss of retinal ganglion cells, progressive optic neuropathy with morphological abnormalities in the optic nerve head and visual field defects, in which raised intraocular pressure is major risk factor. This damage to the ONH causes partial to full loss of the visual field, which is the portion of space in which objects are simultaneously visible in the steadily fixating eye (Harrington, 1976). Damage to visual field is irreversible, however, the loss can be transitory in the early stages of glaucoma. If the condition is untreated the damage to the affected visual field usually worsens and spread until eventually complete loss of vision occurs. The current study aims to correlate few parameters like symmetry of pupillary light reflex, VEP, colour vision defect and visual field defects with optic nerve head changes in glaucoma patients. II. Material And Methods This case control observational study was carried out on patients of Department of Ophthalmology at Acharya Vinoba Bhave Rural Hospital, Sawangi(Meghe), Wardha, Maharashtra from October 2013 to September 2015. A total 100 eyes of 100 patients (both male and females) were enrolled in this study. Study Design: Cross sectional, comparative (case- control) and observational study Study Location: This was a rural hospital based study done in Department of Ophthalmology, at Acharya Vinoba Bhave Rural Hospital, Sawangi(Meghe), Wardha, Maharashtra.