Vascular insufficiency leading to recurrent disc haemorrhage in normotensive glaucoma

Disc haemorrhage is a sign of progression in normotensive glaucoma. We report a case who was presented with right eye (RE) optic disc haemorrhage and retinal nerve fibre layer defect at first visit, he was diagnosed as normotensive glaucoma (NTG). On subsequent follow up visits he had recurrent disc haemorrage and progression in visual fields and optical coherence tomography (OCT). On further evaluation he had h/o of dehydration episodes as he lives in hotter climates and on systemic evaluation he had carotid stenosis and nocturnal dip in 24 hr blood pressure monitoring. This case tells about importance of systemic evaluation in normotensive glaucoma.