Eye Conditions, Eye Treatments, Health, Ophthalmology Clinic

Glaucoma is a condition where the eye’s intraocular pressure (IOP) contributes to the harm of the eye’s optic nerve.

Sometimes in the very early stages of glaucoma, an unusual IOP may not reveal clear cut damage to the optic nerve. The opposite can also happen when an average IOP could damage an optic nerve in a patient weakened by diabetes, poor circulation and other disorders.

Glaucoma Suspect

A glaucoma suspect is an individual that has at least one of the following unusual eye findings in at least one eye:

  1. An IOP greater than 21.
  2. A side vison disturbance that suggests glaucoma
  3. An optic nerve size irregularity or feature such as a splinter-bleed or other

In such cases it is very difficult to know if lowering IOP with glaucoma eyedrops is actually protecting against glaucoma or merely lowering an IOP value in a normal individual.

A very important study (The Ocular Hypertension Treatment Study or OHTS) reported that several ocular circumstances can be high risk for developing disease. These are an unusual IOP, a decreased thickness of the corneal layer and optic nerve enlargement. Such risk factors become important for the prediction who will develop glaucoma and who is only a glaucoma suspect.

Risk Factors for Glaucoma

An ophthalmologist must consider all available data to determine if a patient is a glaucoma suspect or has glaucoma requiring treatment.  Here are some of the factors to consider:

Family history of glaucoma



The patient’s health (diabetes mellitus, systemic hypertension, and cardiovascular disease)

Level of IOP

Shape of the nerve


Photographs showing the shape of the nerve

Thickness of the cornea

Additional clinical tests and follow-up visits with your local eye surgeon such as visual fields and optical nerve scans could differentiate between glaucoma suspect and glaucoma.

glaucoma scan

Computerized optic nerve scan used to evaluate glaucoma suspects