Synopsis
Plan glaucoma reassessment according to control and visual risk, distinguish progression from uncertainty, and address practical treatment barriers before and alongside appropriate escalation.
- Judge glaucoma control through pressure, optic nerve structure and visual function, while considering treatment burden and the risk of lifetime sight loss.
- Check adherence, supply and observed instillation before declaring a pressure-lowering medicine ineffective.
- A measured pressure at target does not exclude progression; reproducible nerve or field deterioration should trigger a review of the target and treatment plan.
Key red flags
A person reporting new painful visual deterioration needs urgent eye assessment even if the last pressure was controlled and the next routine review is months away.
Investigation priorities
Assess current pressure control and look for a change in ocular status.
Management branches
A person attends scheduled follow-up for ocular hypertension, suspected glaucoma or established glaucoma.
- Confirm the diagnostic category, current treatment, functional concerns and any new ocular or systemic symptoms before interpreting the test results.
- Assess pressure control, the quality of structural and field data and the risk of future sight loss, separating no detected change from unresolved uncertainty.
Key medicines
Latanoprost administration when prescribed for ongoing controlFor latanoprost 50 micrograms/mL, deliver a single drop to each prescribed eye every evening and continue the agreed long-term course; resume at the next usual dose after a missed dose rather than doubling.