Does this patient have primary open angle glaucoma?

An overview on the literature on primary open angle glaucoma that has appeared in the optometric and ophthalmological journals during the past ten years indicates a continuing reevaluation, and perhaps at times a seeming disagreement, regarding the parameters of this disease. Opinions have varied, and still do, on such matters as to whether or not the diagnosis of glaucoma is contingent upon a field defect, the existence of low tension glaucoma, the ramifications of ocular hypertension, what constitutes a glaucomatous appearance of the disc, field defects versus the appearance of the disc, field defects versus the appearance of the disc, and what constitutes an early glaucomatous field defect. Voices have been raised in some quarters that claim that waiting for a field defect to develop may not be in the best interest of the patient, and that the glaucoma suspect should be identified as early as possible. Treatment before the development of a field defect is enjoying support from some glaucoma authorities. Good clinical practice will permit the conscientious optometrist to identify those patients who have very early signs of this disease.