This review of Primary Open Angle Glaucoma looks at the management of the condition today. It does this by looking at the following areas: (a) the size of the problem; (b) the position of IOP, with respect to its elevation and fluctuation; (c) optic nerve head changes; and (d) visual function changes. In doing so, it contrasts what is known now with ideas and concepts that were prevalent at the time of the two previous Bowman lecturers, Duke Elder and Drance, as well as noting concepts about the disease that were current at the time of William Bowman. The review concludes by suggesting challenges in this area that lie ahead.