Glaucoma is one of the commonest causes of blindness in the world.1 In the UK, about 7% of people over the age of 75 years have primary open angle glaucoma, the most common type of glaucoma2 and the cause of visual impairment in about 13% of those registered blind.3,4 Early detection and treatment can usually prevent blindness.5 However, half of all patients with primary open angle glaucoma in the UK do not present until vision has begun to deteriorate.6 Here we consider ways of improving detection and management.