Diagnosis and management of open angle glaucoma: suggested guidelines for optometrists.

OBJECTIVE: The aims of this review are to define open angle glaucoma, to outline its prevalence and its financial and personal costs, to discuss the difficulties encountered in establishing the diagnosis and monitoring treatment, and to suggest initial clinical guidelines for the comanagement of glaucoma between ophthalmologists and optometrists. METHODS: The literature was selectively reviewed to permit deductions that can be directed toward an effective comanagement strategy for patients with open angle glaucoma. CONCLUSIONS: Comanagement of patients having open angle glaucoma is a viable option, provided the opportunity for improved monitoring and better compliance is available. The basis for successful management rests with the ability to detect change in the optic disc and surrounding retina, visual fields and intraocular pressure. All these signs are continuous variables for which there are no known limits of normality. The division of responsibilities of management will be established initially by legislation and in the future modified according to experience and the emergence of new therapies.