In this module, we will provide a comprehensive overview of the approach to a patient presenting with chronic visual loss and the importance of not missing a diagnosis of chronic open angle glaucoma. Critical questions to ask in history, including whether visual loss is perceived as a scotoma or absolute blackness and whether there is peripheral visual loss, will be reviewed, as will physical findings, which include increased eye pressure measurements, absence of red reflex, and pale optic nerve. You will learn a comprehensive diagnostic approach to chronic visual loss and will learn to recognize signs and symptoms of chronic open angle glaucoma, a condition that must be evaluated urgently to prevent permanent visual loss. Lastly, you will gain an understanding of the approach and management of some other conditions causing chronic visual loss, such as refractive errors and diabetic retinopathy.