There is no perfect test, like a pregnancy test, which
proves conclusively that a patient has glaucoma. Frequently, the doctor
must make a judgment about the existence of this disease in a patient
based on the results of several tests.
The assessment of
the patient whose examination is suspicious for glaucoma starts with a
careful history. Risk factors include family history of glaucoma,
family history of blindness, the presence of diabetes mellitus or
thyroid disease, and the use of certain medications like systemic
steroids.
The examination includes determination of
intraocular pressure (tonometry), slit lamp examination of the eye, and
evaluation of the appearance of the optic nerve. Many patients benefit
from gonioscopy (a contact lens examination of the eye) and visual
field testing.
Following this thorough examination, the
doctor must use his judgment to determine the presence or absence of
this disease. It is as important to insure treatment of actual disease
as it is to prevent the use of unnecessary medications.
A second opinion is frequently helpful in the evaluation of the glaucoma suspect.
