Study of Corneal Biomechanics in Glaucoma Patients Using Brillouin Microscopy

Inclusion Criteria: \- Age 18 years or older Diagnosis of primary open angle glaucoma (POAG) or no history of glaucoma (for controls) Open angle on gonioscopy (Shaffer grade 3 or 4) Best-corrected visual acuity of 20/25 or better Refractive error between +3.00 and -5.00 diopters No prior use of topical glaucoma medications Diagnosis of: High Tension Glaucoma (IOP ≥ 22 mmHg on 3 visits) Normal Tension Glaucoma (IOP ≤ 21 mmHg on 3 visits) OR age-matched control with normal optic nerve and visual fields Exclusion Criteria: Corneal abnormalities or conditions interfering with Brillouin or applanation tonometry Retinal diseases affecting RNFL (e.g., macular traction) History of ocular surgery or laser Diagnosis of diabetes History of uveitis History of prolonged steroid use Neurodegenerative or systemic diseases (e.g., multiple sclerosis, Alzheimer's, Parkinson's, schizophrenia) Unreliable visual fields Contraindications to beta blockers (e.g., bradycardia, severe pulmonary disease) Moderate to severe glaucoma (per Hodapp-Anderson-Parrish criteria) History of contact lens use Low blood pressure