Preferred Practice Guidelines from the AAO for POAG

Because primary open-angle glaucoma (POAG) can be asymptomatic while also doing great damage to the optic nerve in its early stages, it is critical to detect this disease as soon as possible. The American Academy of Ophthalmology (AAO) recommends a detection process that first assesses a patient’s risk factors and that also utilizes such important traditional tools as visual fields and gonioscopy to achieve a confirmed diagnosis.

According to the AAO practice guidelines for POAG, a visual field for the glaucoma-suspect patient is a key step in assessing “possible glaucomatous disease in the absence of clinical signs of other optic neuropathies.” Gonioscopy is also important in identifying glaucoma suspect patients, according to the AAO guidelines, as “the diagnosis of POAG requires careful evaluation of the anterior chamber angle to exclude angle closure or secondary causes of IOP elevation.”¹

Once the disease state has been confirmed, the main goal of the clinician, according to the AAO, is to “maintain the IOP in a range at which the patient is likely to remain stable.” Here again, the role of regular visual fields testing is critical in monitoring patients for any signs of disease progression.

The chart below shows the recommended follow-up evaluation for patients with POAG.¹

Recommended Guidelines for Follow-up Glaucoma Status Evaluations with Optic Nerve and Visual Field Assessment^*1

The chart is based on Level B (moderately important) and Level III (evidence obtained from one of the following: descriptive studies, case reports or reports of expert committees/organizations (e.g., PPP panel consensus with external peer review).

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