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The optic cup is a center part of the optic nerve, which is typically yellowish/white in color. It is an area of the optic nerve where there is an absence of nerve tissue. Normally the optic cup is on the small side with an area ratio of 0.3 or less in relation to the entire area of the optic nerve. However, in certain conditions, the optic nerve cup can enlarge and the cup-to-disc ratio can be anywhere from 0.6, 0.7, 0.8, 0.9 or even 099! Cupping usually suggests optic nerve damage from glaucoma, which in its advanced stages is can be associated with severe vision loss and is irreversible. Some people do have large optic cups that are congenital. However, to tell the difference between optic nerve cupping that’s physiologic and congenital versus glaucoma, additional glaucoma tests need to be done. The best way to know if you have cupping - whether physiologic or pathologic- is to get a dilated eye exam by your eye doctor. Be sure to get your annual check up to pick up any nerve cupping and prevent damage from glaucoma.