How is disease progression monitored in glaucoma?

• A. Serial optic nerve head exams, OCT of RNFL and ganglion cell layer, and standard automated perimetry
• B. Only intraocular pressure measurements
• C. Annual color vision testing
• D. CT imaging of the orbits

Answer: (A)

Monitoring glaucoma progression relies on tracking both the structure of the optic nerve and the function of vision over time. Serial optic nerve head exams and imaging (such as OCT of the retinal nerve fiber layer and the ganglion cell layer) quantify structural thinning and cupping, while standard automated perimetry measures functional loss in the visual field. This combination is essential because progression can occur even when intraocular pressure is well controlled, and relying on IOP alone may miss ongoing neurodegeneration. Color vision testing isn’t a sensitive indicator of glaucoma progression, and CT imaging of the orbits isn’t useful for routinely monitoring progression.