Early detection is key. In the early stages of glaucoma there are usually no symptoms. The first sign is a change in the normal appearance of the optic nerve head or the adjacent retina. Considerable experience is needed to identify early damage and the underlying mechanism because the normal appearance varies greatly between individuals and the signs are usually subtle. If eye pressure is not elevated these signs are commonly missed. Quite often, the optic nerve is judged ‘suspicious’ and needs to be monitored to see if it changes.
By the time the field of vision is affected, the signs of damage are usually beyond doubt even though most people still have no symptoms. Advanced damage causes a dramatic change in the appearance of the optic nerve head and significant loss of vision, so that the diagnosis will be clear to your optician or to a non-specialist.
The skill of a Consultant Eye Surgeon is in being able to identify problems accurately and at an early stage so that appropriate treatment may be commenced to prevent loss of vision, and also in judging when an optic nerve head that appears odd is in fact normal so that unnecessary investigation and treatment is avoided for people who do not have glaucoma.