Earliest Detection of Asymptomatic Glaucoma (POAG) is Possible, If Patient Has Frequent Complaint of Altered Visual Acuity (V.A) within Last 6 to 8 Months

Purpose: To determine POAG in those patients have normal morphological fundi, C:D ratio and Neuroretinal rim, IOP may or may not significant rised. Background: At first there are no detectable symptoms except history usually given by patients altered acuity and glasses are not working properly, if this frequently complaint 3-4 times for last 8 months suspicion should developed for POAG. Design: Prospective Cohort study. Participant: Selection of Patients is based upon these factors: *Aged >40yrs regardless of gender discrimination. *Those have axial length of eye ball 24.0+/- 2.5mm. *Three or more consecutive visits to OPD for V.A correction within last 8 month. Method: We performed comphrensive Ophthalmic Examination i-e V.A, Ophthalmoscopy, Biomiroscopy, Gold standard Applanation Tonometry. When Patients have complaint persistant change of glasses without any defined morphology aetiology. We investigated these particular group for RNFL thinkness at OCT and measure thickness RNFL of twice in year. Result: There is variation of RNFL thickness in earliest suspected POAG patient with mean RNFL thickness 0.22 +/-0.1 moderate suspected POAG mean RNFL thickness 0.16 +/-0.12 and with healthy patient mean RNFL thickness 0.23 +/-0.03. All have clinical C:D ratio under range 0.2 to 0.5 and IOP under range of 14 to 18mmhg. Conclusion: We analysed the values thickness of RNFL at OCT along supportive history of frequent complaint altered V.A within last 8 months helps to sort out asymptomatic POAG before development of sign and symptoms associated with thousands of axonal death. Once Glaucoma developed, its hallmark of Irrveresible, Progressive, Permanent loss of vision badly affects quality of life.