The Glaucoma Handbook
Welcome to the Glaucoma Handbook.
Murray Fingeret, O.D.
I would like to welcome you to the fifth edition of
the Glaucoma Handbook, a publication developed under the auspices of the Optometric Glaucoma Society
(OGS). This handbook is meant to serve as a guide
the diagnosis and management of glaucoma and is not
an exhaustive review. The material includes a
of basics in regards to glaucoma diagnosis and
while providing new insights into the condition.
goal with each new edition is to keep the material
fresh and up-to-date.
In certain sections, there is
information while all chapters have been updated.
Glaucoma diagnosis and management is in an evolutionary
phase with small improvements occurring. In regards
diagnosis, spectral domain OCTs have been available
18 months with several companies now building these
devices. When first launched, OCT analysis schemes
older methods to assess the data such as TSNIT
and optic disc cross-sectional cuts. The 3-D cube
was not utilized except visually but this is now
changing with new schemes being developed to evaluate
huge amount of data.
On the cover are images taken
with the Carl Zeiss Meditec, inc. Cirrus Spectral
provide examples of where imaging is going. Imaging
both the anterior and posterior segment are
with resolution not previously possible in
instruments. In these examples, the angle and optic
from a healthy individual are seen along with an
of optic disc drusen. The spectral OCTs are evolving
both the Cirrus and RTVue can also image the
segment, and software for glaucoma progression is
able on several instruments.
We should see the release of the Heidelberg Edge
Perimeter (HEP) shortly which continues in the
for early perimetric detection of glaucomatous
Whether the HEP perimeter is a step forward will
be known for several years. Another new functional
test under development is pupil perimetry, which is
objective method to assess central vision and
patient involvement. Similar to the HEP, it will
several years before we know if this will be a
In regards to therapeutics, we are anxiously
the next class of drugs. It has been several years
a new glaucoma drug was made available with
combination drugs being the most recent addition to
medical therapy. Glaucoma surgery is evolving,
slowly, with the quest for procedures that reduce
with fewer complications.
I would like to thank the members of the OGS for
their support and help in developing these
I would like to recommend the OGS electronic
which is available free of charge. It comes out
and covers many different aspects of glaucoma. One
sign up for this at
On behalf of the OGS, I would like to thank our
authors who contributed to this effort. I would
to thank Karen Fixler, Ravi Pherwani, Tom Wright
Jill Burdge from Pfizer for their continuing
the OGS, and specifically for the unrestricted
allowed us to continue with this publication. We
that you find this handbook useful.
-Murray Fingeret, O.D.;
Executive Vice-President, Optometric Glaucoma
Editor, The Glaucoma Handbook