This is a descriptive term for the changes that occur at the optic nerve from glaucoma damage. The optic nerve is the big nerve that connects the eyeball to the brain. It is located at the back of the eye, and its insertion can be seen inside the eye in the retina. This nerve is like a tube or pipe, with over a million individual nerve cell “wires” running through it … kind of like a bundle of wires running through a PVC pipe. With glaucoma, the nerve fibers die off one by one and eventually disappear. With time, this creates a hollowed out appearance to the optic nerve which can be seen during an exam. This hollowed out appearance looks like the inside of a bowl or “cup” and is called glaucomatous cupping. People with advanced glaucoma have significant cupping with hollowed out optic nerves. Some people have the appearance of glaucomatous cupping, but in reality have perfectly normal eyes. This is because some people are born with larger optic nerves … their “pipe” is very large with a lot of excess room inside of it that gives the illusion of nerve loss, but in reality they are perfectly healthy. This anatomical variety is one of the reasons eye doctors take photos and scans of the optic nerve – to see if “cupping” has gotten worse over time.