To evaluate the events leading to a diagnosis of glaucoma.

Medical records of 484 subjects (223 women, 261 men; mean age, 55.3 years) who visited a glaucoma clinic without previous glaucoma diagnosis were reviewed. Events were classified into: 1) glaucoma-related symptoms, such as ocular pain accompanied by intraocular pressure elevation or visual disturbance without other ocular abnormalities except glaucoma, 2) ocular examination by an ophthalmologist for other symptoms, 3) routine health examination, or 4) patient request due to family history of glaucoma. Ocular findings that suggested glaucoma and led to detailed glaucoma assessment were classified as: 1) an optic disc abnormality, 2) high intraocular pressure, or 3) both.

Events that led to the diagnosis of glaucoma were glaucoma-related symptoms in 11.8%, examination by an ophthalmologist in 74.2%, routine health examination in 12.4%, and family history in 1.7% of subjects. Findings that suggested glaucoma in ocular and routine health examinations were an optic disc abnormality in 84.2% and high intraocular pressure in 15.8%; both of these findings were found in 7.4% of subjects.

The most common path to glaucoma diagnosis was optic disc assessment by an ophthalmologist and routine health examination. To facilitate early detection of glaucoma, regular detailed optic disc evaluation by an ophthalmologist should be emphasized.