This is a person who “might” have glaucoma. The diagnosis of glaucoma is not always an obvious one. There is no “one test” that says if a person has glaucoma. Instead, we look at various risk factors to decide if you look “suspicious enough” to have glaucoma. The most obvious risk factor is high eye pressure. If your pressure is “through the roof” … then sure, you probably have glaucoma. The difficulty here is that “normal” eye pressure is different for everyone. Normal pressure ranges from 10 to 21. However, some people have pressures of 25 (or higher) and never develop glaucoma damage. Other people have pressures of 15 and yet are exquisitely sensitive to minor pressure elevations (this condition is referred to as low-tension glaucoma). Other risk factors we look at are family history and circulation problems like migraine headaches. A thin cornea, as measured by pachymetry, has been found to be an independent risk factor for glaucoma, though we don’t know why. As glaucoma progresses, damage occurs at the optic nerve in the back of the eye and the optic disk begins to look hollowed out. This is called glaucomatous cupping. Your eye doctor can examine your nerves with a dilated eye exam and look for this appearance, but once again, some people have “suspicious looking nerves,” but don’t actually have true glaucoma. Finally, we can check for actual vision loss by performing a visual field. Glaucoma damage produces characteristic patterns of vision loss in your peripheral vision. Periodic eye exams are necessary to monitor for pressure fluctuations, photograph optic nerve appearance, and to detect visual field problems. This is all in an attempt to detect early glaucoma so that therapy can start, if needed.