Glaucoma suspect is the term used for individuals in which glaucoma diagnosis cannot be confirmed but also cannot be excluded at the time of consultation. In these cases, a mid- or long-term follow-up associated with proper evaluation may be necessary to unveil the presence of disease.
Although this may be considered an uncomfortable situation, it is important to emphasize for the patient to remain calm, as the inability to establish the diagnosis usually occurs in early glaucoma cases and not in advanced cases in which the alterations are more evident.
The inability to confirm the diagnosis may be due to different causes.
The normal appearance of the optic nerve head shows wide variation in the normal population. And in some cases, it may be difficult to differentiate an early glaucomatous optic disc from an optic disc with an unusual appearance (but with no disease).
All individuals diagnosed as glaucoma suspects or with a positive family history of glaucoma should ideally perform proper documentation of the optic disc appearance and visual function status. These exams should be repeated periodically, in order to compare them for changes along mid and long-term follow-up. Along with other exams, determining the presence of deterioration of these variables with time will confirm (or not) the presence of disease.
The ophthalmologist will discuss with the patient the advantages and disadvantages of different management approaches for this condition. In all cases continuous long-term follow-up is highly recommended, and some eye exams are necessary for proper monitoring.