A 56-year-old African American patient presents to your office for a routine eye exam to update his eyeglasses prescription. During the course of the visit you discover that his IOP is 22mm Hg OD, 21mm Hg OS and his cup-to-disc ratios are .70 OD and .60 OS. Now what? Years ago, the answer was: refer. But today, optometrists are licensed and capable of diagnosing and treating patients with this condition in all fifty states. Thus, I diagnosed him with glaucoma, started therapy and will be following him regularly.For those who are already managing patients with glaucoma, you know how rewarding, challenging and lucrative it can be. For those who are not, here are the essentials of creating a glaucoma practice.Equipment UpgradesThe first step to incorporating glaucoma care into your practice is investing in the right equipment. The bare minimum equipment to properly assess these patients include: Applanation tonometerGonioscopeFundus cameraThreshold visual field analyzer While necessary, it can be costly and you will have to budget accordingly. This list can cost between $50,000 and $60,000, and it’s only the first round of purchases. The next recommendation would be a nerve fiber analyzer—a GDx or an OCT will cost another $60,000 to $80,000—followed by a corneal pachymeter.