Re: Jiang et al.: Optic nerve head changes after short-term intraocular pressure elevation in acute primary angle-closure suspects (Ophthalmology 2015;122:730-7)

The article by Jiang et al1 in the April 2015 issue of Ophthalmology is beautifully done. The authors are to be congratulated for commenting that the rim width “decreased” rather than the rim getting “thinner.” Thickness and width are not synonymous. The optic nerve head has both width and thickness, or narrowness and thinness. The “cup” of the optic nerve can become deeper (i.e., a change in thickness) or wider (i.e., a change in the lateral direction, not the anterior–posterior direction). The finding that width of the neural retinal rim becomes narrower in response to short-term elevations of intraocular pressure is a powerful commentary on the plasticity of the optic nerve head.