Tag: optic nerve evaluation Gurgaon

Optic Nerve Cupping: What Does It Mean When Your Doctor Says Your Cup Is Large?

Optic nerve cupping refers to the size of the central hollow, the cup, within the optic disc at the back of your eye. A large cup does not automatically mean glaucoma, but it is one of the most important findings an eye doctor can make, and it always warrants a thorough explanation.

If you have been told your cup-to-disc ratio is large, or that your optic nerve looks suspicious, this article explains exactly what that means and what happens next.

Understanding the Optic Disc and the Cup

The optic disc is the point where the optic nerve exits the eye, visible as a small, pale, circular structure at the back of the retina. Within this disc is a central depression called the cup. The rim of neural tissue surrounding the cup, the neuroretinal rim, contains the nerve fibres that carry visual information from the retina to the brain.

The cup-to-disc ratio (CDR) describes the size of the cup relative to the overall disc. A CDR of 0.3 means the cup occupies 30 percent of the disc diameter. A CDR of 0.7 means the cup occupies 70 percent.

Normal CDR values vary widely in the population. Most people have a CDR between 0.1 and 0.5. A CDR above 0.6 is considered large and warrants assessment, though it is not in itself a diagnosis. What matters is not just the size of the cup, but the thickness and health of the rim surrounding it.

Why Cupping Happens

Physiological cupping — large but healthy Many people are simply born with a large optic disc and a correspondingly large cup. In these individuals, the neuroretinal rim is intact, the cup has a regular shape, and there is no evidence of nerve fibre loss on OCT or visual field testing. This is called physiological cupping. It requires monitoring, because a large cup makes subtle glaucomatous changes harder to detect, but it is not a disease.

Glaucomatous cupping — the cup enlarging over time In glaucoma, the elevated intraocular pressure damages and kills the nerve fibres in the neuroretinal rim. As fibres are lost, the rim thins and the cup expands, the process called cupping progression. The cup does not just become larger; it changes shape. The rim becomes notched, particularly at the superior and inferior poles where glaucoma tends to strike earliest. The blood vessels at the disc margin may be pushed to one side, a finding called bayoneting, and small haemorrhages may appear at the disc margin.

Glaucomatous cupping is permanent. The nerve fibres that are lost do not return. This is why early detection and pressure control, before significant cupping occurs, is the entire goal of glaucoma management.

Other causes of cupping Non-glaucomatous optic neuropathies can cause cupping that superficially resembles glaucomatous damage. Anterior ischaemic optic neuropathy, a stroke of the optic nerve, can produce cupping with a characteristic pattern of visual field loss. Compressive lesions behind the eye, tumours pressing on the optic nerve or chiasm, can also cause the cup to appear enlarged as nerve tissue is lost. This is one reason a suspicious optic disc always prompts a full assessment rather than an assumption of glaucoma.

What a Large CDR Means in Practice

Being told you have a large cup-to-disc ratio is the beginning of a clinical question, not the end of one. The question is: is this cup large because you were born that way, or because nerve tissue has been lost?

Answering this question requires:

Intraocular pressure measurement: to assess whether pressure is elevated and contributing to nerve damage.

OCT of the optic nerve and retinal nerve fibre layer (RNFL): to measure the actual thickness of the nerve tissue surrounding the cup. OCT can detect thinning before it is visible clinically or before it affects the visual field. A large cup with normal OCT thickness is reassuring. A large cup with thinned RNFL is a significant finding.

Visual field testing: to determine whether the nerve damage, if any, has translated into measurable loss of peripheral vision.

Gonioscopy: Examination of the drainage angle of the eye to assess the type of glaucoma. And to assess whether the angle is open or narrow.

Disc photography or OCT disc imaging: to document the current appearance and establish a baseline for future comparison. Change over time is often more meaningful than a single measurement.

Central corneal thickness: because a thin cornea gives falsely low pressure readings. A patient with a large cup and a thin cornea has a higher true IOP burden than the measured number suggests.

The Cup-to-Disc Ratio Is Not the Whole Story

Experienced glaucoma specialists look beyond the CDR number at several disc features that carry independent diagnostic weight:

Rim thinning — the neuroretinal rim should be thickest at the inferior and superior poles (following the ISNT rule: Inferior > Superior > Nasal > Temporal). Reversal of this pattern, particularly inferior or superior notching, is a red flag regardless of the overall CDR.

Disc haemorrhages — a small splinter-shaped bleed at the disc margin is one of the strongest single predictors of glaucoma progression. It is easily missed on a quick fundus examination and requires careful, dilated disc inspection to detect.

Peripapillary atrophy (PPA) — a zone of pale, thinned retina around the optic disc. Beta-zone PPA, adjacent to the disc, is associated with glaucoma and with areas of RNFL thinning. Its presence and extent add diagnostic information.

Vessel position and bayoneting — Displacement of vessels to the nasal side of the disc as the cup expands is a clinical sign of significant cupping.

Asymmetry between the two eyes — A CDR difference of 0.2 or more between the two eyes is clinically significant even if both values appear within normal limits individually. The eyes should be symmetric; asymmetry raises suspicion.

What Doctors Often Miss Telling You

  • A large CDR in one examination is a starting point, not a conclusion. The most important question is whether it is the same as last year, or larger. Without a baseline photograph or OCT, it is impossible to know. If you have never had disc imaging, ask for it.
  • Disc haemorrhages are transient and easily missed. They disappear within six to twelve weeks. A patient who has a haemorrhage between appointments may never have it documented unless the timing is right. If you notice a sudden change in your vision between appointments, attend sooner.
  • Physiological large cups run in families. If your parent or sibling has been told they have a large cup and investigated thoroughly, and found to be normal, your large cup is more likely physiological. But it still requires proper documentation.
  • You can have glaucoma with a normal CDR. Normal-tension glaucoma, is a type of glaucoma where pressure is within the statistically normal range. It is defined by optic nerve damage and visual field loss despite a pressure that would not be flagged as elevated. The disc changes are real; the pressure number is misleading. A normal IOP does not rule out glaucoma.
  • Race affects optic disc size. People of African descent tend to have larger optic discs, and therefore larger physiological cups, than people of European or Asian descent. A CDR of 0.7 in a Black patient may be completely physiological. However, the same value in a patient of East Asian descent warrants more careful scrutiny. Normative databases used in OCT analysis are population-specific for this reason.

When to Worry

Seek assessment promptly, ideally within days, not weeks, if you notice:

  • A new area of missing or dim vision in any part of your visual field
  • Blurring that is worse in one eye than the other and was not present before
  • A shadow, curtain, or arc of darkness at the edge of your vision
  • A sudden change in colour perception in one eye
  • You have been told in the past that your optic nerve looks suspicious but have never had a full glaucoma workup including OCT and visual fields

If your large cup has never been formally investigated with IOP, OCT, and visual field testing, that assessment is overdue regardless of how long ago you were told about it.

Frequently Asked Questions

What is a normal cup-to-disc ratio?

Most people have a cup-to-disc ratio between 0.1 and 0.5. A CDR above 0.6 is considered large and warrants assessment, though it is not automatically abnormal. What matters is the health of the surrounding neuroretinal rim, the OCT thickness, and the visual field, not the CDR number alone.

Does a large cup-to-disc ratio mean I have glaucoma?

Not necessarily. A large cup can be physiological, simply part of your normal anatomy, or it can indicate glaucomatous damage. Distinguishing between the two requires a full assessment including IOP, OCT, visual field testing, and disc imaging. A single number does not make a diagnosis.

Can optic nerve cupping be reversed?

Glaucomatous cupping, caused by irreversible nerve fibre loss, cannot be reversed. Lowering intraocular pressure stops further damage but does not restore what has already been lost. Some apparent reversal of cupping has been reported in infants and young children after IOP reduction, but this is not observed reliably in adults.

How is optic nerve cupping monitored?

Serial OCT scans of the optic nerve head and retinal nerve fibre layer, combined with visual field testing, are the standard monitoring tools. Disc photographs provide a qualitative record. The goal is to detect any progressive thinning of the neuroretinal rim or worsening of the visual field before vision loss becomes symptomatic.

Can I have a large cup and never develop glaucoma?

Yes. Many people with large physiological cups live their entire lives without developing glaucoma. The cup requires monitoring, ideally with baseline OCT and periodic review, but large cup size alone does not predict disease. The risk is that subtle early glaucomatous changes are harder to detect against the background of an already-large cup. This is why careful long-term follow-up is important.

What is the difference between a large cup and glaucoma?

Glaucoma is a disease of progressive optic nerve damage, defined by characteristic structural changes (thinning of the neuroretinal rim, RNFL loss) combined with corresponding functional changes (visual field defects). A large cup-to-disc ratio is an anatomical observation. Glaucoma requires evidence of damage and, in most cases, a pressure that is too high for that particular optic nerve. The two frequently overlap, but they are not the same thing.

Speak to a Specialist

If you have been told your cup is large, your optic nerve looks suspicious, or your CDR has changed, and you have not had a complete glaucoma workup, that assessment is the right next step. A large cup investigated thoroughly and found to be healthy is genuinely reassuring. A large cup that turns out to be early glaucoma, caught before the visual field is affected, is a vision-saving finding.

Book a consultation: +91 88826 38735 | www.drshibalbhartiya.com

Upload your OCT reports, disc photographs, and visual field results through the website before your appointment.

About the Author

This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.

She has published peer-reviewed research on glaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.

Access her work on Pubmed, Google Scholar, ResearchGate and ORCID.

Dr Shibal Bhartiya
Glaucoma • Second Opinion • Advanced Care

www.drshibalbhartiya.com
 +91 88826 38735

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Neuro-Ophthalmology in Gurgaon

Neuro-ophthalmology helps diagnose complex visual problems that may involve the optic nerve, brain, eye movements, or visual pathways. Symptoms such as unexplained vision loss, double vision, headaches, visual field changes, or difficulty focusing may require a deeper neurological and ophthalmic evaluation.

Neuro-ophthalmology is the subspecialty that sits at the intersection of the eye and the brain. When vision changes cannot be explained by the eye alone — when the optic nerve, the visual pathways, or the brain itself may be involved — a neuro-ophthalmologist is the specialist who connects the two systems and finds the answer.

Dr Shibal Bhartiya is a fellowship-trained neuro-ophthalmologist (from Dept of Clinical Neurosciences, University of Geneva), and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term. Emphasis on early detection, risk assessment, and continuity of care. She is rated 5 stars across 1,500+ patient reviews on Google.

When Your Eyes Tell Your Brain’s Story

Some of the most frightening moments in medicine happen when something changes in your vision and no one can tell you why.

Your eye examination is normal. Your glasses prescription hasn’t changed. And yet something is different — a patch of missing vision, double images that weren’t there before, a headache behind one eye, or a lid that has started to droop. You are not imagining it. And you are not being dramatic.

These are the symptoms that bring patients to neuro-ophthalmology. They are often the first visible signs of conditions that originate not in the eye itself, but in the optic nerve, the visual cortex, or the neurological pathways that connect them. Finding the answer requires a specialist trained to read both systems simultaneously — and to know when a vision symptom is actually a neurological emergency.

That is what this practice offers.

What Neuro-Ophthalmology Actually Covers

Neuro-ophthalmology is one of the most diagnostically complex subspecialties in medicine. It does not treat common refractive errors or cataracts. It addresses the conditions where the visual system and the nervous system overlap — and where missing the diagnosis carries serious consequences.

Optic nerve disease

The optic nerve is the highway between your eye and your brain. Inflammation, compression, ischaemia, and infiltration can all damage it — and each has a different cause, a different urgency, and a different treatment. Optic neuritis, ischaemic optic neuropathy, papilloedema, and compressive optic neuropathy all present with vision loss — but they are entirely different conditions requiring entirely different responses.

Visual field loss and cortical visual pathways

Not all visual field loss originates in the eye. Strokes, tumours, demyelinating disease, and raised intracranial pressure can all produce characteristic patterns of field loss that a trained neuro-ophthalmologist can map to a specific location in the visual pathway. The pattern of loss is often the most important diagnostic clue.

Double vision and eye movement disorders

Diplopia — double vision — is one of the most diagnostically rich symptoms in medicine. It can arise from a nerve palsy, a muscle disorder, myasthenia gravis, a brainstem lesion, or orbital disease. Determining the cause requires a structured assessment of ocular alignment, motility, and associated neurological signs.

Pupil abnormalities

An unequal pupil is never a finding to ignore. Horner syndrome, third nerve palsy, Adie’s pupil, and pharmacological dilation each carry different implications — and some require urgent neuroimaging. Accurate pupil assessment is a core neuro-ophthalmology skill.

Headache and the eye

Many patients with chronic headache, migraine with visual aura, or idiopathic intracranial hypertension first present to an ophthalmologist. Distinguishing migraine aura from transient ischaemic attack, and identifying papilloedema as a sign of raised pressure, requires expertise at the neurology-ophthalmology interface.

Myasthenia gravis and neuromuscular disorders

Ptosis — drooping of the eyelid — and variable double vision that worsens with fatigue are classic presentations of myasthenia gravis. The eye is often the first system affected. Early recognition leads to earlier systemic diagnosis and treatment.

The Diagnostic Capabilities at This Practice

Neuro-ophthalmology diagnosis is only as good as the investigations available to support it. At Marengo Asia International Institute of Neuro and Spine, the following are available under one roof:

InvestigationWhat It Evaluates
MRI Brain and OrbitsOptic nerve, visual pathways, cortical lesions, demyelination
MRA (MR Angiography)Vascular lesions, aneurysms affecting cranial nerves
MRV (MR Venography)Cerebral venous sinus thrombosis, raised intracranial pressure
Carotid DopplerVascular risk in ischaemic optic neuropathy and TIA
Video EEG 24-hourSeizure-related visual phenomena, cortical assessment
EMGNeuromuscular disorders including myasthenia gravis
ERG (Electroretinography)Retinal versus optic nerve origin of visual loss
Vertigo LaboratoryVestibulo-ocular disorders, gaze-evoked nystagmus

This integrated model — ophthalmology and neurology in the same institution — is rare in the Delhi NCR region and eliminates the diagnostic delays that occur when patients are referred between disconnected departments. Dr Shibal Bhartiya is considered one of the best neuro-ophthalmologists in Gurgaon because of her training from AIIMS and University of Geneva, her ongoing research collaborations with Mayo Clinic, Florida, and also her working as Program Director of a neurosciences institute.

Conditions Managed in This Practice

Optic nerve and visual pathway disease

  • Optic neuritis — including MS-related and isolated
  • Anterior and posterior ischaemic optic neuropathy
  • Papilloedema and raised intracranial pressure
  • Compressive optic neuropathy from tumour or thyroid eye disease
  • Leber hereditary optic neuropathy and toxic optic neuropathies

Eye movement and alignment disorders

  • Third, fourth, and sixth nerve palsies
  • Internuclear ophthalmoplegia
  • Nystagmus — congenital and acquired
  • Skew deviation and brainstem gaze disorders

Neuromuscular junction disorders

  • Myasthenia gravis — ocular and generalised
  • Miller Fisher syndrome
  • Chronic progressive external ophthalmoplegia

Pupil and lid disorders

  • Horner syndrome — including urgent workup for carotid dissection
  • Third nerve palsy with pupil involvement — aneurysm exclusion
  • Ptosis — neurogenic, myogenic, and aponeurotic

Headache and intracranial pressure disorders

  • Idiopathic intracranial hypertension
  • Migraine with visual aura — differentiated from TIA
  • Cerebral venous sinus thrombosis

Functional and unexplained visual loss

  • Non-organic visual loss — diagnosis and management
  • Functional overlay in organic disease

To know more, read here

Optic Nerve and Visual Pathway Disease

Double Vision and Eye Movement Disorders

Visual Field Loss

Vision Symptoms

Headache and Intracranial Pressure

Second Opinions

To understand why Dr Shibal Bhartiya is considered the best neuro-ophthalmologist in Gurgaon, read more here.

What to Expect at a Neuro-Ophthalmology Consultation

A neuro-ophthalmology consultation is structured differently from a standard eye appointment. Expect it to take longer — because the history matters as much as the examination.

I will ask about the onset and character of your symptoms, associated headache or neurological features, your medical history including autoimmune conditions, and any recent changes in systemic health. The examination will include visual acuity, colour vision, pupils, eye movements, visual fields, and a detailed optic nerve assessment.

Depending on findings, I may recommend neuroimaging, blood tests, or a formal neurology review. In some cases — particularly where there is any suspicion of raised intracranial pressure, vascular event, or compressive lesion — the pace of investigation will be urgent.

I will always tell you clearly what I think is happening, what I am ruling out, and what the next step is. Uncertainty is part of neuro-ophthalmology — but managed uncertainty, with a clear plan, is very different from not knowing what to do next.

When to Seek Neuro-Ophthalmology Assessment

Come in urgently — within days — if you experience:

  • Sudden painless vision loss in one eye
  • New double vision, especially with headache or facial numbness
  • A drooping eyelid that appeared suddenly
  • Transient vision loss lasting seconds to minutes
  • Vision loss with pain on eye movement

Book a routine neuro-ophthalmology assessment if:

  • You have unexplained visual field loss on a recent test
  • You have been diagnosed with MS and have visual symptoms
  • Your optic nerve looks swollen or pale on a routine examination
  • You have chronic headache with visual disturbance
  • A family member has been diagnosed with a hereditary optic neuropathy

When in doubt, come sooner. In neuro-ophthalmology, the conditions that seem most dramatic are often the most treatable — if they are caught quickly.

Frequently Asked Questions

What does a neuro-ophthalmologist treat?

A neuro-ophthalmologist treats conditions where vision loss or eye abnormalities are caused by problems in the nervous system rather than the eye itself. This includes optic nerve disease, visual pathway disorders, double vision from nerve palsies, pupil abnormalities, and eye findings associated with neurological conditions like MS, myasthenia gravis, and raised intracranial pressure.

How is neuro-ophthalmology different from regular ophthalmology?

A general ophthalmologist diagnoses and treats diseases of the eye — refractive errors, cataracts, glaucoma, retinal disease. A neuro-ophthalmologist focuses specifically on the interface between the visual system and the nervous system. When vision symptoms cannot be explained by the eye alone, neuro-ophthalmology is the appropriate subspecialty.

Is neuro-ophthalmology available in Gurgaon?

Yes. Subspecialty neuro-ophthalmology care is available in Gurgaon. Dr Shibal Bhartiya, known to be the best neuro-ophthalmologist in Gurgaon practices at Marengo Asia International Institute of Neuro and Spine, Sector 56, Gurugram. She is also the Program Director for the institute. The integrated facility includes MRI, MRA, MRV, EMG, ERG, video EEG, and vertigo laboratory under one roof — enabling same-institution multidisciplinary workup without inter-hospital referral delays.

When should I see a neuro-ophthalmologist instead of a neurologist?

If your primary symptom is visual — vision loss, double vision, visual field defect, or optic nerve abnormality — a neuro-ophthalmologist is the most direct route to diagnosis. A neuro-ophthalmologist can perform both the ophthalmic examination and coordinate neurological investigation. If your primary symptoms are non-visual neurological, a neurologist is the appropriate first specialist.

Can neuro-ophthalmology symptoms be an emergency?

Yes. Sudden vision loss, new double vision with headache, a pupil-involving third nerve palsy, or transient vision loss can all represent neurological emergencies — including aneurysm, stroke, or raised intracranial pressure. If you experience sudden onset of any of these symptoms, seek urgent evaluation the same day.

About the Author

This article was written by Dr Shibal Bhartiya, fellowship-trained neuro-ophthalmologist, and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred care and independent second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.

She has published peer-reviewed research on  vison and eye care management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.

1500+ Five Star Patient Reviews Google Business Profile

If you are unable to come to Dr Bhartiya’s clinic: Read more about teleconsultation for glaucoma

Read her research on PubMed | Google Scholar | ResearchGate | ORCID

Upload your reports for a structured review.| www.drshibalbhartiya.com | +91 88826 38735

Leave a review on Google

GLP-1 Agonists and Eye Health: What You Need to Know Before Starting Ozempic or Mounjaro

Posted on by Dr Shibal Bhartiya

GLP-1 receptor agonists, approved for type 2 diabetes management and weight loss, can affect your vision. There is a risk…

Cataract Surgery Does Not Protect You From Glaucoma

Posted on by Dr Shibal Bhartiya

Cataract surgery can improve vision by removing a cloudy lens, but it does not prevent, cure, or eliminate the risk…

Services

Dr Shibal Bhartiya offers glaucoma diagnosis and treatment, second opinions, dry eye, neuro-ophthalmology, paediatric eye care, and specialist consultations at Marengo Asia Hospitals, Sector 56, Gurgaon.

She is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her focus is on identifying risk before damage becomes irreversible, simplifying treatment decisions, and protecting vision long-term. She is rated 5 stars across 1,500+ patient reviews on Google.

Glaucoma Care

Most patients who see Dr Bhartiya for glaucoma are either newly diagnosed and uncertain what to do next, or have been on treatment for years and are not sure it is working. Both are valid reasons to be here.

Specialist Consultations

These are services for patients with specific clinical questions — often patients who have been elsewhere and want a focused, expert assessment.

  • Eye evaluation before GLP-1 agonists (Ozempic, Wegovy, Mounjaro): screening for retinal and optic nerve risk before starting or continuing GLP-1 medications. Dr Bhartiya has published a systematic review on GLP-1 agonists and the eye (PubMed indexed, 2025).
  • Online glaucoma consultation and second opinion: remote consultation for glaucoma, optic nerve concerns, and complex eye conditions, for patients outside Gurgaon and Faridabad
  • Second opinion for complex eye conditions: before any eye surgery, for unexplained vision changes, or when you want clarity before committing to a treatment plan
  • Pre-surgical counselling: understanding options, risks, and benefits before cataract, glaucoma, or refractive surgery
  • Guidance for chronic eye conditions: long-term support and realistic planning for patients managing glaucoma, dry eye, or other ongoing conditions

Ocular Surface Diseases

Screen time, pollution, and contact lens use are driving a quiet epidemic of surface eye disease. Many patients have been told their eyes are “normal” when the problem is simply being missed.

Neuro-ophthalmology

Symptoms like sudden vision loss, double vision, drooping eyelid, or unexplained headache with eye pain often sit at the boundary of neurology and ophthalmology. Dr Bhartiya sees these cases directly.

Paediatric Ophthalmology

Children rarely complain about their vision — they simply adapt. A missed refractive error or lazy eye can affect learning, confidence, and development for years.

Comprehensive Eye Health

Not Sure About Your Diagnosis? You Are Not Alone.

Many patients arrive after a diagnosis elsewhere — unsure whether to start treatment, concerned about long-term progression, or wanting clarity before committing to a plan. A second opinion is not a sign of distrust. It is good medicine.

Request a Glaucoma Second Opinion →

Where to Find Us

Marengo Asia Hospitals, Gurgaon Golf Course Ext Rd, Sushant Lok II, Sector 56, Gurugram 122011 Appointments: +91 88826 38735 | 1800 309 4444 | +91 98187 00269

Teleconsultation is available for patients outside Gurgaon. Dr Bhartiya is happy to work in partnership with your local eye doctor over time.

Full contact details and directions →

Frequently Asked Questions

Do I need a referral to see Dr Bhartiya?

No. You can book directly by calling +91 88826 38735. A referral is welcome if you have one, but it is not required.

Can I get a second opinion if I already have a diagnosis elsewhere?

Yes, this is one of the most common reasons patients come. Bring any reports, scans, or prescriptions you have. You can also upload them in advance for a structured review before your appointment.

What should I bring for my first appointment?

Previous prescriptions, glasses, eye drop bottles if you use them, and any imaging or investigation reports. Full guidance is on the What to Bring page.

Is teleconsultation available?

Yes. Patients outside Gurgaon and Faridabad can consult remotely. Call +91 88826 38735 to arrange.

How long does a glaucoma evaluation take?

A comprehensive glaucoma evaluation including visual fields and imaging typically takes 1.5 to 2 hours. Please plan accordingly.

Does Dr Bhartiya see children?

Yes. Paediatric eye exams, squint, amblyopia, and myopia control are part of regular practice.

I am on Ozempic or a GLP-1 medication. Should I get my eyes checked?

Yes. Emerging research links GLP-1 agonists with retinal and optic nerve changes in some patients. Dr Bhartiya offers a dedicated pre- and on-treatment eye evaluation. Read the published research

About Dr Shibal Bhartiya

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term.

She is Clinical Director of Ophthalmology at Marengo Asia Hospitals, Gurugram, Editor-in-Chief of Clinical and Experimental Vision and Eye Research, and Executive Editor of the Journal of Current Glaucoma Practice, PubMed-indexed, official journal of the International Society of Glaucoma Surgery.

Her 200+ publications, including 90+ PubMed-indexed papers and 28 edited textbooks, span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.

Her work is accessible on PubMed, Google Scholar, ResearchGate, and ORCID.

Full doctor profile → Patient testimonials → Leave a Google review → Upload your reports for a structured review →

Second Opinion | Teleconsultation Online

For patients who live elsewhere, Dr Bhartiya is happy to work in partnership with your local eye doctor to guide and support your care over time.