Superior segmental optic nerve hypoplasia: A diagnostic challenge masquerading as normal-tension glaucoma

Superior segmental hypoplasia of the optic nerve head is a rare, congenital anomaly of the optic nerve head. Clinically, superior pallor of the optic nerve head associated with the corresponding thinning of the nerve fiber layer, superior entry of the central retinal artery, and peripapillary halo are consistent features, along with inferior altitudinal field defects unknown to the patient. All clinical findings may not be present and may mimic glaucomatous optic neuropathy, especially normal-tension glaucoma. We report a similar case of a young individual who was diagnosed and managed as normal tension glaucoma but on careful examination was diagnosed as having a topless disc in both eyes.