Î A diagnosis of primary open-angle glaucoma (POAG) suspect is
established by the presence of one of the following conditions:
a consistently elevated intraocular pressure (IOP), a suspicious-
appearing optic nerve, or an abnormal visual field.
Î Highlights of established risk factors for a POAG suspect diagnosis
include an elevated IOP, family history of glaucoma or glaucoma
suspect, thin central cornea, race, older age, myopia, and type 2
diabetes.
Î The decision to treat a POAG suspect patient may depend on evidence
of optic nerve changes, any visual field defect, level of IOP, and other
associated risk factors.
Î In the Ocular Hypertension Treatment Study (OHTS) overall, 90% to
95% of patients with ocular hypertension did not go on to develop
glaucoma over 5 years, but treatment to reduce IOP also reduced the
risk of developing POAG from 9.5% to 4.5%.
Î A reasonable target for IOP reduction in a POAG suspect patient is
20%, based on the OHTS.
Î Appropriate testing to evaluate and monitor patients with open-
angle glaucoma (OAG) includes gonioscopy, pachymetry, tonometry,
perimetry, careful observation of the optic nerve, and ocular imaging.
Î If a decision is made to treat IOP, options include medical eye drops
or laser trabeculoplasty.
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