Monday, February 27, 2006

Section 1-D: Implications of a Glaucoma Diagnosis

Once a diagnosis of glaucoma is made, there is often fear of blindness and uncertainty about what will happen in the future. Glaucoma is a disease which cannot be cured, but it can be effectively treated to prevent further vision loss. People often fear that they will go blind or that they will have a visual disability. While there are certainly patients who are visually impaired due to glaucoma, this is generally not the rule. If glaucoma is diagnosed and treated early, visual impairment may be limited or minimal.
Once optic nerve tissue is damaged, it is not possible (at least in 2006) to regenerate the damaged nerve fibers. The existing visual field defect or decline in vision from glaucoma is permanent. The goal of treatment, therefore, is to preserve the existing optic nerve. Further optic nerve damage is prevented by lowering the eye pressure. This is done with eye drops, laser treatments, or surgery.
The importance of regular examination schedule with an eye doctor knowledgeable in the treatment of glaucoma is a key factor in preserving sight in glaucoma (Figure 1-16). Not only is continuous and periodic monitoring important, but also adherence to prescribed medical or surgical treatment is critical in preserving the sight. Careful adherence to a schedule for taking glaucoma medications and other treatment regimens is often in the hands of the patient (or patient caretaker) and is the key to treatment success.

Figure 1-16

Previous ~ Chapter 2

Chapter 1. References

Gloster J. Quantitative relationship between cupping of the optic disc and visual field
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Gloster J. Vertical ovalness of glaucomatous cupping. Br J Ophthalmol. 1975;59(12):721-4.

Gloster J, Parry DG. Use of photographs for measuring cupping in the optic disc. Br J Ophthalmol. 1974;58(10):850-62.

Hayreh SS. Pathogenesis of cupping of the optic disc. Br J Ophthalmol. 1974;58(10):863-76.

Hitchings RA, Spaeth GL. The optic disc in glaucoma. I: Classification. Br J Ophthalmol. 1976;60(11):778-85.

Klein BE, Moss SE, Magli YL, Klein R, Johnson JC, Roth H. Optic disc cupping as clinically estimated from photographs. Ophthalmology. 1987 Nov;94(11):1481-3.

Lewis RA, Hayreh SS, Phelps CD. Optic disk and visual field correlations in primary open-angle and low-tension glaucoma. Am J Ophthalmol. 1983;96(2):148-52.

Quigley HA. Early detection of glaucomatous damage. II. Changes in the appearance of the optic disk. Surv Ophthalmol. 1985;30(2):111, 117-26.

Quigley HA, Green WR. The histology of human glaucoma cupping and optic nerve damage: clinicopathologic correlation in 21 eyes. Ophthalmology. 1979;86(10):1803-30.

Spaeth GL, Hitchings RA, Sivalingam E. The optic disc in glaucoma: pathogenetic correlation of five patterns of cupping in chronic open-angle glaucoma. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1976;81(2):217-23.

Wolfs RC, Borger PH, Ramrattan RS, Klaver CC, Hulsman CA, Hofman A, Vingerling JR, Hitchings RA, de Jong PT. Changing views on open-angle glaucoma: definitions and prevalences—The Rotterdam Study. Invest Ophthalmol Vis Sci. 2000;41(11):3309-21.


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