Why are some glaucoma cases not diagnosed after a complete set of tests? Glaucoma diagnosis, especially early diagnosis, is sometimes difficult. Primary glaucoma, especially open-angle glaucoma, cannot be diagnosed based on symptoms, IOP, and visual field examinations alone until typical optic nerve damage is present. High IOP is not a necessary condition for the diagnosis of open-angle glaucoma, because someone may have high IOP; and the fact that IOP is not high does not necessarily mean that it is not glaucoma, except for a small number of people who may have normal IOP glaucoma, and many patients with early glaucoma may have normal IOP during daily office hours. Visual field examinations are subjective, and many people (including intellectuals) do not always have accurate results when they are first examined. This is why there is a clinical diagnosis of “suspicious glaucoma”, which includes suspicious optic nerve, suspicious intraocular pressure (which is what hypertension is), and suspicious atrial angle. In some cases, even after a complete set of tests, including an evoked test (e.g., a negative dark room prone test for suspected closed-angle glaucoma), a definitive conclusion may not be made. All of these require regular follow-up examinations. For suspected glaucoma that cannot be diagnosed conclusively, how often should the tests be repeated? Suspected open-angle glaucoma is usually checked every six months (or three months in some cases) for intraocular pressure, slit lamp microscopy, fundus photography, atrial angioscopy, etc. If the fundus photography is abnormal (i.e., early glaucomatous damage), the visual field (computerized quantitative visual field) is checked. Patients with suspected closed-angle glaucoma are usually told to visit the hospital ophthalmology department or even the emergency room promptly if they have symptoms (eye distention, blurred vision, sudden headache, etc.); those without obvious symptoms can visit the hospital ophthalmology department every 3-6 months to check intraocular pressure, slit lamp microscopy, fundus photography, atrial angioscopy, etc. What is found in the review to confirm the diagnosis? The diagnosis is confirmed when there is typical optic nerve pattern damage during the review of primary open-angle glaucoma. Closed-angle glaucoma is diagnosed when there is atrial angle closure and elevated intraocular pressure, even if no optic nerve pattern damage is present (early closed-angle glaucoma). If there has been no evidence of a diagnosis, is it time to stop rechecking? Suspected glaucoma needs to be reviewed for many years. The exact number of years is not yet supported by evidence. What is the glaucoma provocation test? How is it helpful in confirming the diagnosis? Who is it indicated for? Is there any harm? The darkroom prone test is the more commonly used test for triggering closed-angle glaucoma, and a positive test may be considered for treatment with laser peripheral iridotomy. You can carry Maurobranchiol drops with you during the examination. If the test process induces a significant increase in IOP, you can use its multiple drops for emergency treatment and then seek treatment from an ophthalmologist. Open-angle glaucoma is currently not clinically used to stimulate the test, and the drinking test of earlier years is currently not used. Can I start medication for suspected glaucoma without a confirmed diagnosis? Unless there are high-risk factors, such as high intraocular pressure, medications are generally not needed.