Overview

Glaucoma is not just one eye disease, but a group of eye conditions resulting in optic nerve damage, which causes loss of vision. Abnormally high pressure inside your eye (intraocular pressure) usually, but not always, causes this damage.

Glaucoma is the second leading cause of blindness. Sometimes called the silent thief of sight, glaucoma can damage your vision so gradually you may not notice any loss of vision until the disease is at an advanced stage. The most common type of glaucoma, primary open-angle glaucoma, has no noticeable signs or symptoms except gradual vision loss.

Early diagnosis and treatment can minimize or prevent optic nerve damage and limit glaucoma-related vision loss. It’s important to get your eyes examined regularly, and make sure your eye doctor measures your intraocular pressure.

Diagnosis

These are some of the tests that can establish a diagnosis of glaucoma:

• Measuring intraocular pressure. Tonometry is a simple, painless procedure that measures your intraocular pressure, after numbing your eyes with drops. It is usually the initial screening test for glaucoma.
• Test for optic nerve damage. To check the fibers in your optic nerve, your eye doctor uses instruments to look directly through the pupil to the back of your eye. This can reveal slight changes that may indicate the beginnings of glaucoma.
• Visual field test. To check whether your visual field has been affected by glaucoma, your doctor uses a special test to evaluate your side (peripheral) vision.
• Measuring cornea thickness (pachymetry). Your eyes are numbed for this test, which determines the thickness of each cornea, an important factor in diagnosing glaucoma. If you have thick corneas, your eye-pressure reading may read higher than normal even though you may not have glaucoma. Similarly, people with thin corneas can have normal pressure readings and still have glaucoma.
• Other tests. To distinguish between open-angle glaucoma and angle-closure glaucoma, your eye doctor may use a technique called gonioscopy in which a special lens is placed on your eye to inspect the drainage angle. Another test, tonography, can measure how quickly fluid drains from your eye.

We are handling a case involving the delayed diagnosis of glaucoma.  Early indicators of glaucoma (increased intra-ocular pressure, increased cup-to-disc ratio, and abnormalities on the visual field test) were noticed but not acted on.  Our client meanwhile lost most of her vision.

Jeffrey Beausay