In glaucoma suspects with IOP <22 and fewer than three risk factors, which monitoring components should be tracked?

• A. VF Only
• B. IOP, Disc, OCT, And Visual Field Changes
• C. Disc Changes Only
• D. IOP Only

Answer: (B)

Monitoring glaucoma suspects involves looking at both what the eye is doing (intraocular pressure) and what the optic nerve is showing, structurally and functionally. Even with an IOP under 22 mmHg and only a few risk factors, progression can occur, so a comprehensive plan is warranted.

Keep track of IOP over time to understand pressure trends and fluctuations, since pressure dynamics influence risk and management decisions. Regularly assess the optic disc to spot structural changes such as thinning of the neuroretinal rim, notching, or cupping, which signal nerve damage. Use OCT to quantify retinal nerve fiber layer and related layers; serial OCT measurements can reveal subtle structural loss that might not yet be evident on exam. And routinely perform visual field testing to detect functional loss, confirming progression and showing the patient’s real-world impact.

By combining these four monitoring components—IOP, disc evaluation, OCT, and visual field changes—you maximize the chance of detecting any progression early and making informed decisions about follow-up and treatment.