Patient: 57 years of age, female, autorefraction OD -2.5-0.25/180°, OS -2.75-0.25/5°, BCVA 1.0 at OD, 1.0 at OS, IOP RA 14 mmHg, IOP LA 14 mmHg, pachymetry OD 547 µm, OS 546 µm. General Medical History: Hashimoto thyreoditis. Ocular Medical History: in 2005 parapapillary bleedings with regular visual fields, the 24h-IOP profiles were always 14-16 mmHg at OD and OS without any therapy, there was a regular cerebral MRI . Main complaint: parapapillary bleedings. Purpose: to show transition from pre-perimetric to perimetric glaucoma with a clear glaucomatous change in the optic nerve head over an interval of 7 years from 2006 to 2013. Methods: Fundus Colour Image, w-w-Perimetry 30° Octopus G1, SD-OCT Heidelberg Engineering. Findings: Colour fundus imaging: showing a structural progression of the optic nerve head over 7 years from 2006 to 2013, depicting in 2013 a parapapillary hemorrhage at 11h with minor changes in the retinal pigment epithelium. Visual field : showing minor changes in the visual fields from 2006 to 2007, and in 2008 a clear scotoma. Over 7 years there was a mean loss of 1,2 dB/year and a functional defect of -8.7% per year with an acceleration in the last 3 years. SD-OCT: showing in 2008 a localized defect at 7h, in 2013 a general atrophy and a deep defect at 7h of the retinal fiber layer. The retinal nerve fiber layer showed a decrease from 79 µm to 65 µma over 6 years. Dicussion: In POAG the loss of neuroretinal rim area per year could be very small. Mardin (1) described, that a glaucoma induced rim loss is very small per year and should be differentiated from regular age-related loss. The most pronounced loss in glaucoma is temporal, both superior and inferior. Bengtsson et al (2) examined distributions of rates of progression from visual field series in pseudophakic eyes by Octopus perimeter (Haag Streit AG, Koeniz, Switzerland). They found in glaucoma patients a mean loss of 2.7%/year with the mean defect index MDI. Literature: (1) Mardin CY. Structural diagnostics of course observation for glaucoma. Ophthalmologe. 2013 Nov;110(11): (2) Bengtsson B, Heijl A. A visual field index for calculation of glaucoma rate of progression. Am J Ophthalmol. 2008 Feb;145(2):343-53.