[Follow-up in glaucoma].

Abstract

The follow-up and management of glaucoma are based on the measurement of IOP, on psychophysical examination, and morphological evaluation of the papilla, the nerve fiber layer, and the chamber angle. Applanation tonometry is still the method of choice for IOP measurement. Disinfection with 70% alcohol protects against AIDS. Air-puff applanation tonometry is not exact enough. Although certain authors would like to define primary open-angle glaucoma solely on the changes of the papilla and visual field, we still cannot do without pressure as an indicator for the presence of glaucoma and the quality of therapy follow-up. Additional psychophysical examinations such as color perception, contrast sensitivity, flicker perimetry, and pattern ERG are not yet perfected for the practice and do not replace computerized threshold perimetry. The later has taken a giant step forward with the new evaluation program. However, in spite of these advancements in perimetry, morphology of the papilla and of the nerve fiber layer has assumed such a central role that it must be included in routine glaucoma follow-up. At present, standardized "hand planimetry" is still superior to scanners and laser ophthalmoscopes.