Diagnosis

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Screening for glaucoma is usually performed as part of a standard eye examination performed by ophthalmologists and optometrists. Testing for glaucoma should include measurements of the intraocular pressure via tonometry, changes in size or shape of the eye, anterior chamber angle examination or gonioscopy, and examination of the optic nerve to look for any visible damage to it, or change in the cup-to-disc ratio and also rim appearance and vascular change.

A formal visual field test should be performed. The retinal nerve fiber layer could be assessed with statistical imaging techniques such as optical coherence tomography (OCT), scanning laser polarimetry (GDx), and/or scanning laser ophthalmoscopy or Heidelberg Retina Tomography (HRT3). Owing to the sensitivity of some methods of tonometry to corneal thickness, methods such as Goldmann tonometry should be augmented with pachymetry to measure the cornea thickness.

While a thicker-than-average cornea can cause a false-positive warning for glaucoma risk, a thinner-than-average cornea can produce a false-negative result. A false-positive result is safe, since the actual glaucoma condition will be diagnosed in follow-up tests. A false-negative is not safe, as it may suggest to the practitioner that the risk is low and no follow-up tests will be done.

The Frequency Doubling Illusion can also be used to detect glaucoma with the use of a Frequency Doubling Technology (FDT) perimeter.Examination for glaucoma also could be assessed with more attention given to sex, race, history of drugs use, refraction, inheritance and family history.

Drugs

Intraocular pressure can be lowered with medication, usually eye drops. There are several different classes of medications to treat glaucoma with several different medications in each class.
Each of these medicines may have local and systemic side effects. Adherence to medication protocol can be confusing and expensive; if side effects occur, the patient must be willing either to tolerate these, or to communicate with the treating physician to improve the drug regimen.

Initially, glaucoma drops may reasonably be started in either one or in both eyes. Poor compliance with medications and follow-up visits is a major reason for vision loss in glaucoma patients.
Patient education and communication must be ongoing to sustain successful treatment plans for this lifelong disease with no early symptoms.
The possible neuroprotective effects of various topical and systemic medications are also being investigated