Glaucoma Diagnosis

Over the past 3 millenia, glaucoma diagnostics have evolved from subjective observation to quantitative, objective, accurate, precise measurement. Applanation tonometry has replaced finger tension intraocular pressure measurement; automated perimetry and statistical analysis have supplanted subjective assessment of manual visual field (VF) assessment; and imaging technologies, such as OCT, have provided measurable, unbiased, correct, and reproducible alternatives to clinical observation and optic disc drawings. The net effect of this innovation has been a paradigm shift from dependence on subjective physician interpretation to incorporation of objective data for discerning the presence and progression of glaucoma from health and stability. Ophthalmologists are now able to detect glaucoma and its progression earlier than ever before, enabling precise and personalized clinical decision-making that ultimately serves patients by triggering escalations of treatment even before the development of grossly detectable damage. Further, the objective, quantitative, accurate, and precise measures allow expert diagnosis to occur without the necessity of an expert observer. This permits high-quality glaucoma care in nearly any setting.