Optic nerve head drusen and glaucoma.

The simultaneous occurrence of both optic nerve head drusen and glaucoma may make it difficult to evaluate visual field defects and the appearance of the optic nerve head. We saw five patients with both conditions, of whom four had pigmentary glaucoma or pigmentary dispersion syndrome. Drusen do not preclude the development of cupping, and they make it difficult to interpret its significance. Management of these patients requires serial visual field testing, serial disc photographs, and treatment aimed at keeping the intraocular pressures as low as possible.