Glaucoma is a disease that damages the optic nerve of the eye. It is usually associated with an increased pressure in the eyes, however it is possible to have glaucoma with normal eye pressure and it is possible to have high eye pressure and not have glaucoma.

The incidence of glaucoma is three per cent in the US and a recent survey showed 15 per cent of Barbadians over the age of 45 have glaucoma.

There are several types of glaucoma. The most common form, diagnosed in over 80 per cent of patients, is known as chronic or simple glaucoma. This disease is slowly progressive, painless and symptomless over a period of years so that patients are unaware that the disease is pre- sent. The first symptoms appear when the disease is quite advanced.

When glaucoma is diagnosed in the early stages patients often default or are inconsistent with their medications. This is so because they can't discern any benefits or advantages from complying with their treatment schedule. This is because the disease in the early stages is asymptomatic. The disease affects the "side vision" so that the patient is unable to appreciate the loss of vision.

 Patients with advanced glaucoma quite often have normal 20/20 vision and can read all the letters on the doctor's wall chart. More important than reading the wall chart is checking the side vision by doing a "visual field" test. It is not possible to "catch" glaucoma from anyone but the risk of getting glaucoma is higher if one's family has it. There are genetic risk factors. Diabetics, very short sighted patients and hypertensives have a higher incidence of glaucoma. There is also a greater risk of glaucoma with the use of certain drugs and with eye injuries. The incidence in people of African descent is higher than in other ethnic groups. The older the patient the greater the risk-of developing glaucoma.

Patients diagnosed with glaucoma are usually started on eye drops by their ophthalmologist. The patient is unaware whether the medication is working so that his doctor will review them in two to four weeks to determine the effectiveness of the medication. 1f it is effective the ophthalmologist will adjust the medication and will continue to do so every two to four weeks until the desired effect is obtained. If more than a drop is placed in the eyes at any time, they are put in about ten minutes apart.

If you have any risk factors for glaucoma you should see an ophthalmologist. Though optometrists and general practitioners can play an important role in screening for glaucoma, only an ophthalmologist is qualified to diagnose and treat glaucoma. After an examination the ophthalmologist will advise on how often follow-up examinations are necessary.