This article is more than 5 years old. Information may no longer be current.
Different stages of glaucoma call for different management strategies
Click Here to Manage Email Alerts
NEW YORK — Glaucoma develops though five stages, and being familiar with the stages may help physicians develop better management strategies for their patients, said M. Bruce Shields, MD. Dr. Shields spoke here at Columbia University's New Frontiers in Clinical Glaucoma II conference.
Despite advances in research, Dr. Shields said, the disease and its development still need study.
“Now that we have an understanding of all five stages, we should be able to be more precise in how we treat these patients, but we’re not, really,” he said. “All patients are still receiving similar treatment.”
Researchers have identified the five stages of glaucoma as initial event; early tissue alterations, such as changes in the aqueous outflow system; pre-neuropathy events, such as elevation of IOP; optic neuropathy; and visual field loss. The last two stages represent manifest glaucoma, he said, while the first three are pre-glaucomatous stages.
The time between initial event and early tissue alterations may be as short as a few seconds, if the event is caused by ocular trauma, or could be as long as decades if the cause is a genetic defect, he said.
Pre-neuropathy events include the initial outflow obstruction, often due to pigment deposition in the trabecular meshwork, Dr. Shields said.