These patients are said to have ocular hypertension. Most patients with glaucoma do have elevated intraocular pressure. Glaucoma may occur in infancy or childhood, but is most common in adults. The most common type of glaucoma is primary open angle glaucoma. This is usually completely painless and most patients are not aware that they have it unless they undergo a thorough eye examination.
Loss of vision is usually very gradual and occurs over many years.
Narrow angle glaucoma may be seen in an acute form, with sudden onset of severe pain, blurred vision, and very high intraocular pressure, or in a chronic form, with gradual loss of peripheral vision due to optic nerve damage. Inflammatory eye diseases, severe eye injuries, some hereditary conditions, and cortisone-related steroid medications may also cause glaucoma. In most patients, glaucomatous damage to optic nerve fibers results in a gradual loss of peripheral vision. This is detected with a visual field test, usually performed on an automated computerized visual filed analyzer that can accurately map out the peripheral vision and compare it to age-based norms and to previous visual field tests performed on the same patient. This trend of visual field loss progression over time is very important in the monitoring and management of glaucoma.