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Primary Open-Angle Glaucoma

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Î The optic nerve should be carefully examined for the above signs of glaucoma damage, and its appearance should be serially documented. (I+, M, S) Î Eye care providers can view the optic disc and RNFL using magnified stereoscopic visualization with the slit-lamp biomicroscope and through a dilated pupil. (I+, M, S) Î Eye care providers evaluate the visual field using standard automated perimetry (SAP) with white-on-white stimuli. It is the gold standard test for comparing other types of visual field testing. (II, G, S) Î Although they are distinctly different methodologies, stereoscopic disc photographs and computerized images of the nerve are complementary with regard to the information they provide the clinician who must manage the patient. In the absence of these methodologies, a nonstereoscopic photograph or a drawing of the ONH should be recorded, but this is a less desirable alternative to stereophotography or computer-based imaging. (III, In, S) Î Because some patients show visual field loss without corresponding optic nerve progression, both structural and functional assessments remain integral to patient care. Even though quantitative imaging technology is approved as an adjunct to aid in glaucoma diagnosis, the clinician should include all perimetric and other structural information when formulating patient management decisions. (III, In, S) Î Routine genetic testing for glaucoma risk alleles is NOT recommended for patients with POAG at this time. (III, G, S) 3

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