The brief I have been given is;
A major source of variability of optic nerve measurements (e.g. CD Ratio) is the size of the optic disc. This dissertation will investigate the effect of optic nerve size on the detection and management of glaucoma.
I need the dissertation to explain the physiological variability of the optic nerve head focusing specifically on; cup/disc ratios, small cups and small discs, large cups and large discs, and how cup/disc ratio needs to take the disc diameter into account. When talking about physiological variability of the optic nerve head, stay away from the topic of atrophy of the disc.
The dissertation has two main parts, detection and management. The detection aspect should consider the optic nerve head and cupping, raised intra-ocular pressures and visual field defects as separate sections. As glaucoma is a large disease, I need the dissertation to relate back to primary open angle glaucoma and acute angle closure glaucoma. Asymmetry between the two eyes in cup/disc ratio and intra-ocular pressure measurements also needs to be covered explaining what is physiological and what is pathological with experimental evidence.
The bulk of the dissertation needs to focus on the management aspect. Questions along the lines of what are the results of treatments? What is the management for suspicious discs with pathologically large cups? And do large/small discs respond differently to treatment? need to be addressed with experimental evidence. Current treatments for glaucoma can also be written about, including the use of Optical Coherence Tomography scanners and how they aid management. Also, a question on this is how much do OCT scanners take disc size into account?
Management of asymmetry between the eyes for asymmetric discs and asymmetric intra-ocular pressure readings can also be a part, but results need to be backed up by experimental evidence.
The paper cannot be a re-write of the anatomy of the eye or an explanation of pathophysiology only, however I do understand that certain aspects need explaining.
I can only use journals for this dissertation, so please do not use any web links as references.
