Examination of the Eye

It is important to routinely perform a complete ophthalmological examination including dilated slit-lamp examination and peripheral retinal examination, in addition to the specific glaucoma evaluation in all patients with glaucoma. In primary open-angle glaucoma (POAG), there are few ocular signs; therefore, a diagnosis of POAG is really a diagnosis of exclusion. Ophthalmologists should view themselves as diagnostic sleuths, evaluating for unusual causes and considering new insights into mechanisms of the disease, including in patients with apparent POAG. Because the glaucomas involve multiple pathogenic mechanisms, the observant and inquisitive clinician is able to make important discoveries about known as well as new forms of glaucoma. This can only happen as a result of a complete and meticulously documented full ophthalmo-logical examination.