Comment surveiller un glaucome agonique ?

End-stage glaucoma is characterized by a near total structural loss and similarly deteriorated visual function. It is very difficult to follow patients in this stage of the disease by standard automated perimetry. The purpose of this article is to discuss how to better follow patients with end-stage glaucoma. Monitoring of glaucoma must take into account the measurement of intraocular pressure, structural evaluation and functional assessment. Structural evaluation has only minor importance at this stage, and the most useful tool is qualitative analysis, especially through stereo disc photography, looking for disc hemorrhages. Conversely, functional assessment is of major importance. Specific techniques and strategies should be used. Patients' complaints are very important in this stage of glaucoma. Trial frames are very useful for accurate testing of visual acuity, and are preferable to phoropters. Visual field measurement must be adapted to this end stage of glaucoma, by using targeted strategies, such as: testing the central 10 degrees, testing a 24-2 field with a size V stimulus, and Goldmann perimetry. Any slight sign of worsening must be taken into account, so as to detect any progression of the disease