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[Psycho-functional and objective tests applied to early diagnosis of POAG, indications for general ophthalmologists and therapeutic incidences].

The early diagnostic of glaucoma (before the appearance of visual field defects) can be made in some cases with the help of certain objective tests and, to a lesser degree, with subjective or psychophysical tests. Retinal nerve fiber layer photography is certainly the most rewarding objective test, providing the technique has been mastered and there is a clear fundus view without chorio-retinal atrophy. The identification of nerve fiber defects is an almost sure sign of glaucomatous damage in the absence of other pathology. An abnormally small neuroretinal rim area can also be an indicator of glaucoma. However, no conclusion can be drawn if the value is within the wide range of normal limits. Electrophysiological tests in glaucoma patients at the present time give results that show too much variability and overlap with those of normals to be of practical value. The same can be said for subjective tests such as spatial and temporal contrast sensitivity (the flicker test, for example). The specificity and sensitivity of the tests are too weak to be useful for the diagnosis of glaucoma in 1992.