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Glaucoma, Suspect, Adult Follow-up

  • Author: Robert H Graham, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Sep 02, 2014
 

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.

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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.

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Patient Education

Patients should be educated regarding their risk factors, prognosis, and the importance of follow-up care. Glaucoma can cause silent damage with eventual vision loss.

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education articles Adult Glaucoma Suspect, Glaucoma FAQs, Normal-Tension Glaucoma, and Ocular Hypertension.

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Contributor Information and Disclosures
Author

Robert H Graham, MD Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona

Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, Arizona Ophthalmological Society, American Medical Association

Disclosure: Partner received salary from Medscape/WebMD for employment.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Martin B Wax, MD Professor, Department of Ophthalmology, University of Texas Southwestern Medical School; Vice President, Research and Development, Head, Ophthalmology Discovery Research and Preclinical Sciences, Alcon Laboratories, Inc

Martin B Wax, MD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, Society for Neuroscience

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, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

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, American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgements

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

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