Question

A 65yo man presents to the clinician with c/o increasing bilateral peripheral vision loss, poor night vision, and frequent prescription changes that started 6mo previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

a. The presence of increased intraoccular pressure measured by tonometry is definitive for the dx of open-angle glaucoma.
b. The clinician can definitively diagnose open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist.
d. Early dx is essential in order to revers any damage that has occurred to the optic nerve.

Answer 1

The diagnosis of chronic open-angle glaucoma relies on a gonioscopic evaluation by an ophthalmologist, not solely on increased intraocular pressure or patient complaints, and existing optic nerve damage cannot be reversed.

Step-by-step explanation:

Concerning the diagnosis of chronic open-angle glaucoma, the correct statement is c. Physical diagnosis relies on gonioscopic evaluation of the angle by an ophthalmologist. While increased intraocular pressure measured by tonometry can indicate a risk for glaucoma, it is not definitive for diagnosis on its own. Patient complaints provide clinical clues but cannot definitively diagnose the condition. Lastly, treatment of glaucoma aims to prevent further damage rather than reversing existing damage to the optic nerve, as the damage is typically irreversible.