The best laid schemes o' Mice an' Men, Gang aft agley …

Unfortunately, the words of the Great Scot, Robert Burns, are apropos once again, this time with regard to our cover story. We had great hopes of being able to report significant progress in automating the seemingly ever-more complex task of diagnosing glaucoma when we came up with this story idea. Best laid schemes. It's always tempting to think that no matter how complex a challenge is, the right combination of knowledge, planning, perspiration and technology will solve it. That may turn out to be true—someday—with automated glaucoma detection. Not yet.

But that's not to say you can't learn, actually a lot, from asking the question. And for a heck of an interesting "failed" article idea, check out Chris Kent's article this month.

For further support of the headline above, you might also check out the May issue of Ophthalmology. In the lead article, Duke University researchers offer an appropriately cautious but fascinating report on the potential role of decreased cerebrospinal fluid in primary open-angle glaucoma. As if you needed further evidence that glaucoma is indeed far more complicated than increased intraocular pressure.

The reality is that the art and science of detecting glaucoma will depend for the foreseeable future on an observant, proficient and informed diagnostician. On that front, you may also want to visit the newly launched website: In its healthcare professionals section you'll find the Optic Nerve Physician Resource Center, which contains comprehensive, non-commercial reviews of available imaging technologies, case studies and other resources gathered from experts around the world, all designed to improve the detection and ongoing management of glaucoma.

As tempting as it may be to wish otherwise, glaucoma may never lend itself to a single diagnostic solution. It will continue to depend on the clinician's skill and judgment. And that's not such a bad thing.