Do computerised visual fields and automated optic disc analysis assist in the choice of therapy in glaucoma?

The choice of therapy in patients with glaucoma is determined by the presence of damage in the visual field or optic disc or by change in the appearance of the optic disc or visual field over time. Computerised visual fields and automated optic disc analysis can assist in this determination. Automated optic disc analysis permits the measurement of neuroretinal rim area which is more closely related to the presence of pathology than cup/disc ratio. Simple ophthalmoscopic techniques may also be used to estimate the size of the neuroretinal rim area. Automated perimetry allows accurate diagnostic information to be obtained in a reliable manner. This permits easier diagnosis of glaucoma as well as easier long term follow up for change. The availability of automated techniques in ophthalmology has helped the clinician in the choice of therapy. The use of astute clinical judgement remains however of the utmost importance.