Glaucoma Diagnosis: Past, Present and Future

Glaucoma diagnosis is one of the most challenging situation in ophthalmology. In daily clinical practice, many of glaucoma patients are missed on diagnosis and a lot of those receiving antiglaucoma therapy may not have the disease. This difficulty may be attributed to sensitivity and specificity of the diagnostic tools as well as the nature of disease in its early stages. In the past, subjective clinical evaluation of optic nerve head and Retinal Nerve Fiber Layer (RNFL) photography enabled diagnosis but with wide variability even among expert observers. Visual field analysis is a major subjective beneficial test, but requires patient cooperation, frequently shows fluctuation. Even tests with reliable indices should be repeated several times to ensure a reproducible defect.