The next step: detailed assessment of an adult glaucoma patient

Although there are many possible causes of glaucoma (e.g. trauma, inflammation, previous surgery, or an inherited tendency), it is usually possible to identify the mechanism of elevated IOP by careful history taking, anterior segment examination, and optic disc assessment using a slit lamp. After assessment, the clinician can group the glaucomatous optic neuropathies into three main categories: primary open-angle glaucoma (POAG), primary angle-closure glaucoma (ACG), and secondary glaucomas (including pseudoexfoliation, pigmentary, uveitic, lensinduced, neovascular, steroid-induced and traumatic). As a group, the glaucomas are chronic, life-long diseases, and it is therefore essential to collect and record clinical data accurately so that patients with progressive disease or who develop other ocular pathology can be identified at an early stage.