Glaucoma is a group of conditions characterized by damage to the optic nerve (detected by eye examination) and loss of the visual field.  The two main types are primary open-angle glaucoma and primary angle-closure glaucoma.  As the early stages of both types of glaucoma are often symptomless, patients often present late, particularly in developing countries. Once vision has been lost, regardless of the type of glaucoma, it cannot be restored. 

Primary open-angle glaucoma

Primary open-angle glaucoma cannot be prevented.  We manage this by long-term use of eye drops to reduce intraocular pressure or by surgery (e.g. trabeculectomy).  We also follow up by long-term monitoring of the visual field, optic disc and intraocular pressure.

Primary angle-closure glaucoma

Acute attacks of primary angle-closure glaucoma and more chronic forms of the disease can be prevented by early detection.  Treatment of established primary angle-closure glaucoma requires surgery to the iris or medication to reduce intraocular pressure, followed by long-term monitoring.