Aim: To investigate the relationship of optic nerve head changes with visual field defects to establish a correspondence between structural and functional damage.

Material and Method: One hundred and thirty six eyes of 70 patients having glaucomatous disc damage constituted material for this prospective observational study.A detailed history and ocular examination was carried out. Optic nerve head changes were classified as disc changes, vascular changes and peripapillary changes. Optic nerve head changes were correlated with different visual field changes. Data were compiled and analyzed.

Result: The male female ratio was 39:31. The mean age was 53.85 years. The mean intra ocular pressure IOP was 29.41 mm Hg. More than one type of optic nerve head changes were seen in many patients. Enlargement of blind spot was seen in isolation or in combination with other visual field defects leading to some overlapping. Approximately one third patients showed no field defects. Neuro retinal rim notching, disc border hemorrhage and Retinal Nerve FiberLayer defects show a definite correlation with visual field defect. However, other optic nerve head changes may not follow any specific pattern of visual field loss.

Conclusion: Although, neuro retinal rim notching, disc border hemorrhage and retinal nerve fiberlayer defects show a strong correlation with visual field defects, other optic nerve head changes do not always correspond with the visual field defects.The glaucomatous damage and monitoring of disease progression require measurement of both structural and functional changes.