Abstract: The lamina cribrosa is affected by intraocular pressure, which is the major risk of glaucoma. However, the capability to evaluate the lamina cribrosa in vivo has been limited until recently due to poor image quality and the posterior laminar displacement of glaucomatous eyes. In this study, we propose an automatic method to measure the anterior lamina cribrosa surface depth (ALCSD), including a method for detecting Bruch's membrane opening (BMO) based on k-means and region-based active contour. An anterior lamina cribrosa surface segmentation method based on energy constraint is also proposed. In BMO detection, we initialize the Chan-Vese active contour model by using the segmentation map of the k-means cluster. In the segmentation of anterior lamina cribrosa surface, we utilize the energy function in each A-scan to establish a set of candidates. The points in the set that fail to meet the constraints are removed. Finally, we use the B-spline fitting method to obtain the results. The proposed automatic method can model the posterior laminar displacement by measuring the ALCSD. This method achieves a mean error of 45.34 μm in BMO detection. The mean errors of the anterior lamina cribrosa surface are 94.1% within five pixels and 76.1% within three pixels.