Diagnosis of glaucoma in the ageing eye
• An examination of the neuroretinal rim and surrounding retinal nerve fibre layer is necessary to detect glaucomatous optic neuropathy.
• Glaucoma often affects the superior and inferior poles of the disc.
• Presence of disc haemorrhage and/or retinal nerve fibre layer defects is very suggestive of glaucoma.
• Reproducible visual field changes may be the first sign of glaucoma.
• Quantification of progressive disc/RNFL changes may be aided by analysis of serial confocal scanning laser ophthalmoscopy or OCT images.
• Pointwise analysis for VF progression is more helpful than use of global indices.
• Using glaucoma change software is more reliable than clinical judgement alone in estimating visual field progression.