THE CHALLENGES OF DEFINING GLAUCOMA AND ITS PROGRESSION

Roger Hitchings

Professor of Glaucoma, Moorfields Eye Hospital, England

We can not define glaucoma as an optic neuropathy and recognise it by a characteristic deformation of the surface of the optic nerves.  With increase in sophistication of psychophysical tests and objective optic disc scanning we are diagnosing glaucoma at an ever-earliest age in the disease process, although early detection allows greater scope for preserving sight by retarding the rate of progression.  It also allows less scope for misdiagnosing through methodological errors.  This presentation will discuss methods of identifying early disease as well as identifying changes in the rate of progression.  It will concentrate on standard psychophysical test and objective tests that are able to measure rate and will describe methods by which these forms of evaluation can be used in clinical management.