Glaucoma is a poorly understood disease in which most often there is a raised pressure inside the eye, and in the long term this can cause damage to the retina nerve and lead to blindness. Unfortunately it is not as straight forward as this would suggest, and there are many factors which contribute to the final damage of the nerve in addition to, or instead of, simply raised pressure.
Glaucoma is a disease associated with increasing age so that the risk of developing this disease increases substantially as one moves through the later decades of life, particularly from 60 onwards. However, the disease can occur in younger patients and even in children.
Disturbingly, most forms of common glaucoma occur in a slowly progressive fashion without the patient’s knowledge. There is a peripheral constriction of vision with central vision (i.e. that used for reading and driving) remaining normal until close to the final stages of the disease. In most cases it is only by regular check-ups that the disease is identified.
Unfortunately, any loss of vision from glaucoma is usually permanent.
The rationale of treatment in most patients is to reduce the pressure in the eye and thereby hope that further progressive loss of vision will not occur. Unfortunately, this is not always the case and this fact probably is explained by our lack of understanding of the basic disease process of glaucoma.
Most patients can achieve control of their pressure and thereby maintenance of existing vision and field of vision by the use of drops. Although these may need to be taken for the rest of the patient’s life, only a small percentage of patients need to go onto laser treatment or actual cutting surgery.