A new definition and classification system was proposed recently for primary angle closure glaucoma. This system emphasizes on the characteristic progressive end-organ damage - "glaucomatous optic neuropathy", and attempts to adopt a uniform definition of glaucoma, synonymous with primary open angle glaucoma. This approach represents a departure from convention, in which individuals with a narrow drainage angle combine with either raise intraocular pressure or peripheral anterior synechiae but without glaucomatous optic neuropathy, are said to have primary angle closure rather than primary angle closure glaucoma. Although the use of this definition has been adopted by the American Academy of Ophthalmology and Southeast Asia Glaucoma Interest Group, it is still debatable on whether this should be adopted in China. We attempt to describe the background of the development of this new classification scheme, discuss its advantages and challenges.