Primary Open-Angle Glaucoma

A 58-year-old man presents to the ophthalmology clinic for routine eye examination. He is asymptomatic and denies any visual complaints. On examination, intraocular pressure (IOP) is 24 mmHg in both eyes (normal <21 mmHg). Gonioscopy reveals an open angle with normal trabecular meshwork appearance. Optic disc examination shows a vertical cup-to-disc ratio of 0.7 with inferior neuroretinal rim thinning and a flame-shaped hemorrhage at the disc margin. Automated perimetry shows a superior arcuate scotoma. What is the most appropriate next step in management?

A 58-year-old man presents with elevated intraocular pressure (IOP) of 28 mmHg in both eyes and optic disc cupping. Gonioscopy shows open angles. Visual fields are normal. He has no contraindications to any class of glaucoma medications. What is the drug of choice for initiating monotherapy in primary open-angle glaucoma?

A 58-year-old man with primary open-angle glaucoma (POAG) is being evaluated for disease progression. His intraocular pressure (IOP) is 22 mmHg on topical prostaglandin analogue monotherapy, and visual field testing shows early glaucomatous changes. Which of the following is NOT a recognized risk factor for progression in POAG?

A 58-year-old Indian man with a 5-year history of treated hypertension presents for routine eye check-up. Examination reveals IOP 24 mmHg (both eyes), healthy optic disc with normal cup-to-disc ratio, and normal visual fields. Gonioscopy shows open angles with mild trabecular meshwork pigmentation. Which finding best distinguishes this patient's ocular hypertension from established Primary Open-Angle Glaucoma?

A 58-year-old man presents to the ophthalmology clinic with a family history of glaucoma. On examination, intraocular pressure (IOP) is 22 mmHg in both eyes, optic disc appears normal, and visual fields are intact. Gonioscopy shows open angles. Which investigation is most appropriate to confirm the diagnosis of primary open-angle glaucoma (POAG)?