A patient has an intraocular pressure of 24 mmHg in one eye and 20mmHg in the other eye. The first eye is above the threshold for treatment but would colleagues start treatment to both eyes ?
Check for any secondary cause for glaucoma on Slit Lamp Ocular Exam . In case any cause found ,it's indication to start therapy.
If no secondary cause do a baseline Visual Fields and OCT scan .
Follow up in 3 months with repeat of scans to check any progression .
If any change, only then it warrants therapy.
Do a glaucoma work up: Optic nerve head evaluation, OCT scan, VF, pachy. History is also very important in this case. If everything is normal/not remarkable, monitor
Full examination. History, Clinical,CCT, OCT, Visual fields, Curve. If angle open, optic nerves normal, OCT and visual fields normal, and if these IOPs are the "roof" of IOP diurnal curve, then no need ror therapy, just follow up.
Good evening
Careful history should be taken
Examination of the angle of the anterior chamber is needed
Measuring the intraocular pressure with diurnal variation
Discussion of different type of treatment with the patient
No need to start treatment at this point. But patient ha to be on regular follow up. Every visit, we have to look for intra ocular pressure, optic disc evaluation and OCT for retinal nerve fibre layer thickness. If positive, it's the time to start our treatment and on frequent follow ups