What is a notable exam finding in patients with untreated primary open-angle glaucoma?

In untreated primary open-angle glaucoma, a significant and notable exam finding is excessive cupping observed during a fundoscopic examination. This occurs due to the gradual loss of optic nerve fibers, which leads to an excavation or "cupping" effect in the optic disc. The increased intraocular pressure characteristic of glaucoma contributes to this damage over time.

While increased intraocular pressure is indeed a relevant factor in glaucoma, it is not always present in every patient, particularly in the early stages. Excessive cupping, on the other hand, is a definitive finding that indicates optic nerve damage, making it a particularly important sign in diagnosing and managing the disease.

Furthermore, bleeding in the retina and clouding of the lens are not characteristic findings associated with primary open-angle glaucoma; rather, they pertain to other ocular conditions. Focusing on excessive cupping helps practitioners understand the progression of glaucoma and the necessity of early intervention to prevent vision loss.