HOW WE MEASURE DAMAGE AND INJURY IN GLAUCOMA

J.S. Schuman

New England Eye Center, Tufts University School of Medicine, Boston, MA, USA

All glaucomas follow a final common pathway of retinal ganglion cell death, resulting in retinal thinning, optic nerve cupping and loss of visual function.  Traditional means for assessment of glaucomatous damage include intraocular pressure measurement, clinical observation of the optic nerve and nerve fiber layer, and assessment of the visual field.  New technologies allow objective, quantitative evaluation of the optic nerve and retinal structures with a high degree of precision.  New methods for measuring visual function assessment include technologies for early detection with enhanced sensitivity and specificity.  Techniques are currently being developed for objective, quantitative visual function evaluation using electrophysiologic means.  Since intraocular pressure is not an adequate diagnostic test for the assessment of damage and injury in glaucoma, advances in structural and functional measures of the optic nerve are critical.