Glaucoma is a disease which is generally asymptomatic and unless patients are monitored by a glaucoma specialist, they will not realise that their eye condition is getting worse. The condition worsens due to a loss of nerve fibres in the optic nerve as a result of pressure inside the eye.
It is also important to stress that once the vision damage has occurred from glaucoma, it is not reversible.
The type of progression depends on the type of glaucoma, the level of the intraocular pressure and the severity of glaucoma.
For example, some types of secondary glaucoma (caused by other conditions in the eyes) can have very high pressures which lead to a progression of glaucoma within weeks. Some patients with primary open-angle glaucoma, on the other hand, may only have a very slow progression of their condition that takes a few years.
However, it is important to remember that if you already have severe damage to your vision caused by glaucoma, a slight progression of your condition can have a devastating effect on your vision.
In general, there are six tests/examinations which form the basis of monitoring patients with glaucoma.
n general, patients with stable and early primary open-angle glaucoma will only need to be reviewed every 6 to 12 months, whilst those with severe and unstable secondary glaucoma may need to be reviewed every few weeks.
It is worth pointing out that if you have advanced glaucoma, a minimal progression may lead to significant permanent visual impairment and therefore it is imperative that patients with advanced glaucoma are monitored much more regularly.
Overall, about 20% of patients with glaucoma will require surgery in their lifetime. It is usually offered to patients if the glaucoma is still worsening despite trying non-invasive treatments.
However, if you presented to the glaucoma specialist with advanced or secondary glaucoma, the chance of you needing surgery will be much higher. This does not include non-invasive treatments such as SLT laser, which most patients with primary open-angle glaucoma will likely to have at some point.