eMedicine Specialties > Ophthalmology > Intraocular Pressure

Glaucoma, Suspect, Adult: Follow-up

Author: Robert H Graham, MD, Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona
Contributor Information and Disclosures

Updated: Mar 19, 2009

Follow-up

Further Outpatient Care

  • The frequency and the composition of follow-up evaluation depend on the age of the patient, the level of elevation of IOP, the appearance of optic nerve head cupping, a family history of glaucoma, the presence of additional risk factors, and the stability of the patient's clinical course.
  • In general and depending on the patient's risk factors, check IOP every 3-12 months. If the patient is a low-tension glaucoma suspect with normal IOP but suspicious optic nerve head cupping, conduct a diurnal assessment of IOP.
  • Perform visual field examinations every 6-12 months. If a new visual field defect is suspected, the test should be repeated (preferably within 1 mo) to ensure that the defect is reproducible.
  • Gonioscopy and optic nerve head evaluation are generally performed annually.
  • Baseline documentation, such as stereo disc photographs, should be obtained for future comparison to objectively evaluate any possible subtle progression. In selected patients, some ophthalmologists prefer to obtain this documentation yearly for detailed comparison.

Prognosis

  • Most patients who are glaucoma suspect do not develop glaucomatous optic nerve damage and/or visual field loss.
    • Overall, about 1% of individuals with ocular hypertension develop glaucoma per year.
    • The risk is higher for patients with additional risk factors.
  • Glaucoma causes silent damage; follow-up care is essential to exclude any progressive change over time that may warrant treatment.
  • Left untreated, patients with optic nerve damage may progress, resulting in progressive loss of side vision and eventually total optic nerve atrophy and irreversible blindness.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to properly and periodically test adults who are suspected of having glaucoma
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor, U Fusun Cardakli, MD, to the development and writing of this article.



More on Glaucoma, Suspect, Adult

Overview: Glaucoma, Suspect, Adult
Differential Diagnoses & Workup: Glaucoma, Suspect, Adult
Treatment & Medication: Glaucoma, Suspect, Adult
Follow-up: Glaucoma, Suspect, Adult
References
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Further Reading

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Keywords

glaucoma suspect, glaucoma, IOP, intraocular pressure, high pressure inside the eye, elevated intraocular pressure, elevated IOP, POAG, primary open-angle glaucoma, ocular hypertension, OHT, ocular hypertensives, optic nerve head, optic nerve damage, visual field defect, vision loss, blindness, glaucoma risk, glaucomatous optic nerve

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Contributor Information and Disclosures

Author

Robert H Graham, MD, Senior Associate Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona
Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, and Arizona Ophthalmological Society
Disclosure: WebMD/eMedicine Salary Employment

Medical Editor

Bradford Shingleton, MD, Assistant Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary
Bradford Shingleton, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Martin B Wax, MD, Clinical Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Ophthalmology Research and Development, Head, Ophthalmology Discovery Research, Alcon Labs, Inc
Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Society for Neuroscience
Disclosure: Alcon Labs Salary Employment

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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