Introduction and Context
Glaucoma is a leading cause of irreversible vision loss worldwide. Clinicians rely on a combination of structural imaging (optical coherence tomography, OCT), visual field testing (standard automated perimetry, SAP), and clinical examination to detect and monitor glaucomatous optic neuropathy. Visual electrophysiology—objective tests that measure retinal and visual pathway function—has long been explored as a complementary approach to identify retinal ganglion cell (RGC) dysfunction earlier than perimetry or to clarify ambiguous cases.
In June 2026 the American Academy of Ophthalmology (AAO) published a focused evidence review: “Visual Electrophysiology for the Diagnosis of Glaucoma.” This report systematically evaluated contemporary literature (search through August 2025) and synthesized how electroretinography (ERG) variants and visual evoked potentials (VEP) perform for glaucoma diagnosis. The AAO panel concluded that electrophysiology shows promise but is not yet ready for routine clinical use. This article summarizes that report’s rationale, core recommendations, evidence strength, practical implications, and areas for future work.
