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Rretrnfl4oclockthicknessoct

Published: August 9, 2026Updated: August 17, 2026

A non-invasive eye imaging test that measures the thickness of the nerve fiber layer in the right retina to detect early signs of glaucoma and other optic nerve diseases.

Quick summary

{"Uses optical coherence tomography (OCT) to create detailed images of the retina","Measures the retinal nerve fiber layer thickness at specific clock hours","Helps detect glaucoma and optic nerve damage before vision loss occurs","The test is quick, painless, and requires no special preparation","Results are compared to normative databases to identify abnormalities"}

Medically reviewed by WellAlly Editorial TeamLast reviewed August 17, 2026Editorial policy

Key facts at a glance

LOINC
86308-4
Short code
RNFL-OCT-RH4
Synonyms
R ret RNFL 4 o'clock thickness OCT
Category
cardiac
Sample
serum
Container
Not applicable - this is an imaging test, not a blood collection
Units
N/A
Ref low
70
Ref high
110
Critical range
40 N/A – 10000 N/A
Fasting
false
Population
adult
Sex
all
Age range
≥ 18 years
Method
Optical Coherence Tomography (OCT)
CPT
92134
SNOMED
371625004
Specimen volume
Not applicable - imaging test
Stability
Not applicable - imaging test
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
24–72 hours
Order
routine

What is this test?

The Right Retina Retinal Nerve Fiber Layer (RNFL) Clock Hour 4 Thickness test is an advanced imaging procedure that uses Optical Coherence Tomography (OCT) to measure how thick the nerve fiber layer is in a specific area of your right eye. The retina contains layers of nerve cells that transmit visual information to your brain. The retinal nerve fiber layer (RNFL) is the innermost layer made up of nerve fiber axons that bundle together to form the optic nerve.

Why is clock hour 4 measured specifically?

The optic disc (where the optic nerve exits the eye) is divided into 12 equal sections like a clock face. Clock hour 4 corresponds to a specific region of the optic nerve head. Measuring thickness at this particular location helps doctors identify localized thinning or damage to the nerve fibers, which can be an early indicator of glaucoma or other optic neuropathies. Different clock hours may show damage earlier than others depending on the type of eye condition.

How is the test performed?

During the test, you will sit in front of the OCT machine and rest your chin on a support. The technician will ask you to look at a fixed target while the device scans your eye. The OCT machine uses harmless light waves to create cross-sectional images of your retina. The entire procedure takes about 5-10 minutes per eye and is completely painless. No eye drops or injections are required, and there is no radiation exposure.

What will the results show?

Your results will show the thickness measurement of the RNFL at clock hour 4 in microns (μm). The doctor will compare your measurement to a database of normal eyes to determine if your RNFL thickness is within normal range. Thinner than average RNFL may indicate nerve damage, while thicker than average measurements might suggest swelling or other abnormalities. The doctor will consider these results along with other eye exams to make a diagnosis.

Reference range

Normal Retinal Nerve Fiber Layer (RNFL) thickness at clock hour 4 ranges from 70 to 110 micrometers. Values below 50 micrometers suggest significant RNFL thinning suggestive of glaucoma or optic nerve pathology.N/A

Specimen: serum

Patient should remove contact lenses prior to imaging. Pupil dilation may be performed for better visualization but is not always required. Inform technician of any eye surgery history, glaucoma, or optic nerve disorders.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings2

Frequently asked questions

Does the test hurt?
No, the OCT scan is completely painless. You may feel slight pressure from the chin rest, but there is no discomfort. The bright light from the machine may feel intense for a few seconds, but it is not harmful.
Do I need to prepare for the test?
No special preparation is needed. You can eat and drink normally before the test. However, you should avoid wearing eye makeup on the day of the exam as it may interfere with the imaging. If you wear contact lenses, you may be asked to remove them before the scan.
How long does it take to get results?
The actual scan takes only a few minutes. Your eye care provider will typically analyze the results and discuss them with you during the same appointment or within a few days.
How often should I have this test?
The frequency depends on your eye condition and risk factors. For glaucoma patients, testing may be done annually or more frequently to monitor disease progression. Your doctor will recommend an appropriate schedule based on your specific situation.
What happens if my RNFL is thinner than normal?
If your RNFL thickness is below normal, your eye care provider will evaluate the results along with other findings from your eye exam. This may indicate early glaucoma or other optic nerve conditions. Your doctor may recommend additional testing, more frequent monitoring, or treatment to prevent further vision loss.
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 17, 2026. · Read our editorial policy