What are the clinical signs of a more chronic glaucoma?

• A. Haab's striae
• B. Mydriasis
• C. Aqueous flare
• D. Cupped optic nerve

Answer: (A)

Chronic glaucoma is best recognized by glaucomatous optic neuropathy, which shows up as cupping of the optic nerve. As retinal nerve fibers are lost over time, the neuroretinal rim thins and the cup-to-disc ratio increases, often with associated visual field loss. This excavation of the optic disc is the classic sign of long-standing glaucomatous damage.

Haab's striae are horizontal breaks in Descemet's membrane seen in congenital (pediatric) glaucoma, not in the typical chronic, adult form. Aqueous flare reflects inflammation in the anterior chamber (uveitis), not glaucomatous damage. Mydriasis is just pupil dilation and is not a defining feature of chronic glaucoma.