Glaucomatous damage of the optic nerve is characterized by progressive increase in cupping with loss of neuroretinal rim.  Clinically, this will appear as a deepening of the cup with a widening of the cup-to- disc ratio and progressive loss of neuroretinal rim area(#21990).  In its end stages, the cupping is quite extensive with almost complete loss of normal optic nerve head tissue.  Seen on gross examination, the optic nerve is white and atrophic with a deep cupping and extreme nasal displacement of vessels(#21991).  Histopathologically, the most prominant change seen in glaucoma is that of extensive cupping with posterior bowing and compressions of the tissues of the lamina cribrosa

(#21993).  There is often an undermining of the tissue at the rim of the scleral canal(#21994).  There is extensive atrophy of axonal tissue and displacement of vessels from the retina.  The optic nerve tissue itself may show marked atrophy of axons with increased gliosis in the optic nerve parenchyma (#22219).  The retina shows atrophy (#22436) or complete absence of the ganglion cell layer in end-stage glaucoma (#22217).

(#22394, #22397, #22400) are other slides showing loss of ganglion cells secondary to glaucoma.

Slides (#22406, #22409, #22412, #22415, #22484, #22487, #22490, #22493, #22496, #22499) show glaucoma-associated cupping of the optic nerve.