Diagnostic evaluation of the patient suspected of having glaucoma.

From the preceding it can be seen that the clinician still has little to help him decide which of his patients with elevated intraocular pressure will advance to frank glaucomatous disease. There are no objective provocative tests that will reliably predict the future. Consequently, one must obtain as much data as possible about an individual patient and, combining all these facts, have either a high or low degree of suspicion. Once a patient is noted to have elevated pressure, however, he must remain a glaucoma suspect, perhaps for the rest of his life. Only the subsequent examination will determine if glaucoma is continuing to be absent (or clinically undetectable) or whether it has actually become clinically manifest. The need for periodic reevaluation is obvious. Careful documentation of the disc, field, and applanation intraocular pressure over a period of time remains the most important aspect of the diagnostic evaluation of the patient with elevated intraocular pressure.