ABSTRACT
Glaucoma is the second cause of blindness after cataract worldwide, and the first cause of irreversible vision loss (source: AHAF). 1 Decades of medical scientific research led to the conclusion that ‘glaucoma’ is most appropriately used with reference to a group of ocular disorders with multi-factorial aetiology (Casson et al. 2012). The common feature of them is the degeneration of optic nerve fibres, a neuropathy that leads to blindness if untreated. In contrast with other case studies in this volume, and in spite of continuing efforts on the part of the scientific community, glaucoma’s diagnostic and therapeutic solutions are at best partially effective. The onset of disease is often asymptomatic and several forms of glaucoma are simply hard to detect or too aggressive for effective prevention. But, even in the case of timely diagnosis, visual impairment due to glaucoma is still a likely outcome. On the one hand the therapeutic regimes currently available can slow down but not reverse progressive damage to the visual field. On the other hand, glaucoma therapy is still anchored in the tradition of lowering intra-ocular pressure (IOP) in spite of clinical evidence showing that the latter is a risk factor only for some forms of glaucoma. As a result, the efficacy of treatment varies significantly depending on ‘which glaucoma’ affects an individual, as well as on other factors such as lifestyle and ethnic group.
