Glaucoma resulting from secondary congenital, ocular, or systemic conditions represents a formidable diagnostic and management challenge for optometrists. This paper discusses the pathogenesis, diagnosis, and treatment of six common forms of the disease: exfoliation syndrome, pigmentary glaucoma, neovascular glaucoma, lens-induced glaucoma, glaucoma accompanied by ocular inflammation, and trauma-induced glaucoma. For each of these conditions, clinical experience, observational skills, and an understanding of the mechanisms by which elevated intraocular pressure may result are prerequisites for accurate diagnosis. Management requires that the intraocular pressure be reduced and that the underlying condition be diagnosed so that other appropriate treatment may be initiated. Follow-up is predicated on risk factors, relative control of the intraocular pressure, and the fragility of the optic nerve.