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Glaucomatous optic nerve damage is associated with changes in the parapapillary region. These changes were measured on 15 degrees color stereo slides of the optic nerve head. We examined 450 eyes of 330 patients suffering from chronic primary open-angle glaucoma and 200 eyes of 161 normal subjects. The glaucoma group was divided into five stages according to the neuroretinal rim configuration. In the parapapillary region, the "alpha" zone characterized by irregular hypo- and hyperpigmentation, and the "beta" zone (large visible choroidal vessels and visible sclera) were differentiated. Zone "beta" was located between the optic disc and zone "alpha". Both zones were significantly larger in the total glaucoma group (p less than 0.00001, Mann-Whitney-test), and in each of the five glaucoma stages, than in the normal subjects. Zone "beta" increased in size more than zone "alpha". The parapapillary region deserves special attention in the diagnosis of glaucoma.
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