A glaucoma consultation has five stages: history and vision check, comprehensive eye examination, glaucoma tests, dilation if needed, and eye drop training. The tests follow a fixed order, with visual field and imaging first and gonioscopy last. Plan for abut two hours, and bring your old reports.
Every consultation ends with practical education on how to use eye drops correctly and simple strategies to improve treatment adherence. Successful glaucoma care depends on both accurate diagnosis and consistent treatment.Want to know what your results will mean? Read What Should My First Glaucoma Review Tell Me?
Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term. Emphasis on early detection, risk assessment, and continuity of care. She is rated 5 stars across 1,500+ patient reviews on Google.
A Doctor’s Walkthrough the Glaucoma Consultation
Most patients walk into a glaucoma consult expecting a quick pressure check and a prescription. What they get instead, in my clinic, is a sequence. History, vision, anterior segment, a deliberate order of imaging and gonioscopy, baseline pressure testing across more than one visit. The final ten minutes that I consider non negotiable, teaching you how to actually use your drops.
I have refined this sequence over years of glaucoma practice because the disease itself demands it. You cannot feel your eye pressure changing. You cannot feel your nerve fibre layer thinning. The only way to catch glaucoma early and keep it from progressing is a structured, repeatable, slightly unglamorous process. Repeated the same way every single time.
This page walks through that process exactly as it happens in my clinic. So that you know what to expect. It also helps you plan your day better.
Quick Answer: A glaucoma consultation in my clinic moves through five stages. First, the optometrist takes a detailed history and checks vision. This includes uncorrected vision, best corrected vision, and vision with your current glasses. Second, I review that history myself and examine the front of your eye. Third, I run structural and functional tests in a specific order. Corneal thickness, then pressure measurement, then gonioscopy, with OCT and visual field testing done before gonioscopy when they are needed. Fourth, if your pupils need to be dilated, you wait about forty five minutes. Fifth, no consult ends without me personally teaching you how to instil your eye drops correctly and how to remember whether you have taken them.
How to Prepare for Your Glaucoma Consultation
A little preparation before your appointment can make your glaucoma consultation more useful and help your ophthalmologist understand your eyes over time.
If possible, bring any previous eye records, including OCT scans, visual field reports, optic nerve photographs, eye pressure readings, and details of any eye surgery or laser treatment. If you use glaucoma eye drops, bring a list of your medications or the bottles themselves. It is also helpful to know whether anyone in your family has glaucoma or significant vision loss.
Write down any questions or changes you have noticed since your last visit, even if they seem minor. Most importantly, do not stop using your prescribed eye drops before your appointment unless your ophthalmologist has specifically advised you to do so.
The more complete your previous records, the easier it is to compare changes over time—because in glaucoma, understanding what has changed is often more important than any single test result.
Read more at What to bring to your glaucoma consultation.
Stage 1: The Optometrist Does the Groundwork
Every consult starts with my optometrist, not with me. This is deliberate. Your history gets captured properly, and your vision gets measured in a structured way, before I walk into the room.
History taking
The optometrist takes a detailed history. They also review any reports, scans or visual fields you bring, and note all of it in your file.
This includes conditions that seem unrelated to the eye: diabetes, high blood pressure, heart disease, asthma, or autoimmune disease. They also record your current medicines and known allergies. Your body affects your glaucoma treatment choices, so none of this is skipped.
Three vision measurements, not one
Your vision is checked with a formal refraction. Three separate numbers are recorded:
- UCVA (uncorrected visual acuity): what you see with no glasses at all
- PGP (present glasses power): what you see with the glasses you wear now
- BCVA (best corrected visual acuity): what you could see with the ideal prescription
Together, these tell me whether a vision problem comes from your glasses, your ocular surface, or your optic nerve. I know this before I examine you.
Sometimes the optometrist takes a non-contact pressure reading as a screen. I still insist on Goldmann applanation tonometry for every glaucoma patient.
Stage 2: I Review Your History and Examine Your Eye
When you come in to see me, I read through everything the optometrist has recorded. If something looks incomplete or inconsistent, I ask more questions before we move on.
There is always a few minutes of ordinary conversation too. A glaucoma consult is a long relationship, not a transaction. I treat you as a person before I treat your test results. You will be surprised by what I remember: your family, your last holiday, your dog 🙂 sometimes even your favourite chutney.
I then examine the front of your eye, and the retina and optic nerve in detail. This test is done at the slit lamp, with a 90D lens. The conjunctiva and ocular surface, the meibomian glands, the eyelid and bulbar conjunctiva, the anterior chamber, and the lens, looking specifically for cataract, a shallow anterior chamber, or any cells in the anterior chamber (inflammation). At the back of the eye I look at the vitreous, the retina, the macula, the optic nerve, and the peripapillary retinal nerve fibre layer.
Stage 3: Glaucoma Tests, in a Fixed Order
I follow the same order every time, because each test can affect the next. When they are part of your visit, the order is:
- Visual field
- Imaging (OCT and fundus photographs)
- Corneal thickness (CCT)
- Eye pressure (IOP)
- Gonioscopy
Visual field first
I start with your visual field. It tests how well your optic nerve works, before anything touches your eye.
There is a learning curve to this test. Your first attempt is often unreliable, because you have not yet learned its rhythm. I routinely discard the first field and ask you to come back the next morning. We do not charge for the repeat. The inaccuracy belongs to the test, not to you.
Imaging next
Next comes OCT, and fundus photographs if needed. They show the structure of your optic nerve and nerve fibre layer. Together with your visual field, they give me a clean functional and structural baseline.
Corneal thickness before pressure
I measure central corneal thickness (CCT), also called pachymetry, before I measure your pressure. Corneal thickness changes how I read your pressure number. Touching the cornea first can also alter the reading slightly. So CCT always comes before IOP.
Why I measure your pressure myself
Goldmann applanation tonometry (GAT) is the one test I do not delegate. I perform it myself for every glaucoma patient before treatment starts, at the first follow-up, and at every annual review. My optometrists are trained to do it, and they do it in my absence. Doing it myself gives me a feel for your eye that a number on a chart cannot.
For the test, a team member puts in numbing drops and asks you not to touch your eye. I then add a dye that stains your tears yellow. I check your pressure under blue light on the slit lamp, with a small prism that comes close to your eye.
It takes less than a minute if you keep looking straight ahead and don’t blink. It is painless, and we finish with a drop of antibiotic.
Gonioscopy last
Gonioscopy examines your drainage angle under magnification. It tells me whether your angle is open or narrow. It presses a lens on your eye, so I do it last, once your other results are recorded.
I do my own gonioscopy, always with the lights switched off. So be ready for a few minutes in a dark room. I keep talking to you throughout, so it is never scary. Sometimes I use a viscoelastic gel. If I do, your vision stays fuzzy for about ten minutes afterwards.
Building a true baseline
I never base a decision on one reading on one day. Pressure rises and falls through the day.
So for a true baseline, I usually take three pressure readings at different times of day. An optometrist may take one of them if it falls outside my working hours. We work from the average of all three.
A full diurnal test, with readings every few hours, is not practical for everyone. We often use the water drinking test as a practical stand-in. I do it before starting treatment, and again one to two months after treatment begins. I may repeat it if your glaucoma progresses despite your pressure meeting its target.
Stage 4: Dilation, When It Is Needed
Some assessments need your pupils dilated. If yours do, I tell you in advance. Dilation takes about forty-five minutes to work fully, and it changes how you experience the rest of your day.
- Bring dark glasses, a scarf or an umbrella. Dilated eyes are far more sensitive to light, especially in Gurugram’s daytime heat.
- Do not drive yourself home after a dilated examination.
Stage 5: Your Plan, Your Target Pressure, and Eye Drop Training
Your personal target pressure
Modern glaucoma care has no single normal pressure. I combine your corneal thickness, your drainage angle, and your visual field and OCT baseline. From these, I set a target pressure for your eye. It is the pressure that should halt progression for you.
Eye drop training
A prescription does not protect your vision if the drops go in wrongly or get forgotten. So every consult ends with practical training, not just instructions.
- I personally show you how to instil your eye drops. Technique affects how much medicine reaches your eye.
- I ask you to set a phone alarm for every dose. Relying on memory alone is a common reason treatment fails.
- If you use more than one bottle, keep two small boxes: one full, one empty. After each dose, move that bottle across. One glance then tells you which drops you have taken and which remain.
- My coordinator books your next appointment before you leave. You also get a WhatsApp message with useful links and booking numbers, plus my direct number for clinical queries or emergencies.
When To See Me Before Your Booked Glaucoma Consultation
- Sudden eye pain, redness, or blurred vision, which can signal an acute angle closure attack
- Any one sided change in vision or eye appearance
- Headache or nausea accompanying eye pain
- A noticeable change in your visual field between scheduled visits
- New side effects after starting or changing a glaucoma medication
- Missed doses for several consecutive days, which should be flagged at your next visit rather than left unmentioned
Book Your Glaucoma Consultation in Gurgaon
Now you know how the visit runs, from the optometrist workup to your eye drop training. If you have glaucoma, a family history, or a pressure reading that worries you, come and see it for yourself.
Bring your old reports and your eye drop bottles. Do not stop your drops before the visit unless your ophthalmologist has told you to. If your pupils need dilating, arrange a lift home. If all your tests need a repeat, plan for two hours. If you’re coming for a second opinion with fresh reports, twenty to thirty minutes.
Cannot travel to Gurgaon? Upload your reports through the second opinion form, and we can plan a teleconsult.
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This page is a part of the Glaucoma Hub. you may want to read about Glaucoma Progression, and Risk Stratification in Glaucoma. Other articles of interest could be Advanced Glaucoma Care in Gurgaon, What Good Glaucoma Care Actually Optimises For, What Happens If Glaucoma Is Left Untreated?, More Glaucoma Eye Drops is Not Better Glaucoma Care, 5 Mistakes Patients Make in Glaucoma Care and Do You Really Need Treatment for Glaucoma?
Frequently Asked Questions
Why does the optometrist see me before the doctor does?
The optometrist’s workup, history, refraction, and the three part vision check, ensures your file is complete and your baseline vision is documented accurately before I begin my own examination. This makes the time I spend with you more focused on interpretation and decision making rather than data collection.
Why do you measure my eye pressure yourself instead of leaving it to staff?
Goldmann applanation tonometry is the gold standard pressure test, and for every glaucoma patient I treat, I perform it myself before starting treatment, at the first follow up, and at every annual review. It gives me a direct sense of your eye’s behaviour that I do not want to lose by always delegating it.
Why do you discard my first visual field test and ask me to repeat it?
Most patients have not yet learned the rhythm of the visual field test on their first attempt. This makes that first result unreliable. We ask you to return the next morning for a repeat test. We do not charge for it, since the inaccuracy belongs to the learning curve of the test, not to you.
Why is gonioscopy the last test, not the first?
It presses a lens against your eye. I want your visual field, scans and pressure recorded cleanly before that. With a viscoelastic gel, your vision blurs for about ten minutes, so I also don’t want your time wasted.
What is the water drinking test and why would I need one?
It is a practical way of checking how your eye pressure responds to a physiological stress. This is used in place of round the clock diurnal variation testing, which is not feasible for every patient. I typically use it before starting treatment. I may repeat it again a month or two into treatment. And again later if your eye appears to be progressing even though your pressure looks controlled.
Why do you spend time teaching me to put in my own eye drops?
Technique directly affects how much medication reaches your eye. A missed or mistimed dose is the most common reason glaucoma treatment underperforms. Pairing a phone alarm with the two box system is simple. It gives you a simple, visual way to know whether today’s dose has already gone in. Research says it is the most important intervention in preventing glaucoma blindness.
Is Dr Shibal Bhartiya the best glaucoma specialist in Gurgaon?
Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist with over 25 years of experience. Her training includes AIIMS New Delhi and the University of Geneva. She is a Mayo Clinic Research Collaborator, has authored over 200 scientific publications, edited 28 ophthalmology textbooks, and has more than 1,700 five-star Google reviews from patients. While there is no objective one best doctor for glaucoma, lot of her patients call her the best glaucoma specialist in Gurgaon.
What do patients say about Dr Shibal Bhartiya’s care, beyond her credentials?
Patients consistently describe feeling heard, never rushed, and receiving clear, personalised explanations. Many value her ethical approach, thoughtful second opinions, and focus on preserving both vision and quality of life. Many reviews also describe her as the best glaucoma specialist or eye doctor in Gurgaon.
Key Takeaways
- Your consult begins with the optometrist. They document history and perform three vision measurements, UCVA, PGP, and BCVA, before I examine you
- Testing follows a fixed order: imaging and visual field first when needed, then corneal thickness, then gonioscopy, then pressure measurement
- I personally measure your eye pressure for every glaucoma patient at key visits, rather than delegating it
- Your first visual field is usually repeated free of charge, because of a genuine learning curve with the test
- Baseline pressure is built from three readings at different times of day, sometimes supplemented by a water drinking test
- Your target pressure is personalised to your eye’s anatomy, not based on one generic normal number
- No consult ends without hands on training in how to use your drops. And how to track whether you have taken them
About the Author
This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also the Program Director for Community Outreach & Wellness; and for the Marengo Asia International Institute of Neuro and Spine.
Dr Bhartiya has published peer-reviewed research onglaucoma management, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes. She is also a committed patient advocate and mainstream medical columnist, translating complex ophthalmic evidence into actionable public health insights across leading national platforms including NDTV and OnlyMyHealth
As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery). Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.
1700+ Five Star Patient Reviews Google Business Profile
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Read her research on PubMed | Google Scholar | ResearchGate | ORCID | Github | Wikidata
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Last Reviewed: October 2026
