Clinical Course O

Patients with POAG typically have a slow, insidious loss of vision. This is contrasted by the course of acute PACG which can lead to rapid vision loss that develops over hours to days. For POAG, only 4% to 8% of patients may progress to legal blindness. It may take 13 to 16 years for a patient to go blind from glaucoma. A patient's quality of life may not be affected until significant visual field loss is present and the

patient can no longer perform the activities of daily living. Vision loss does not occur until there has been significant loss of the retinal ganglion cells. Peripheral vision is the most susceptible to glaucomatous damage, with central vision being preserved until advanced disease progression has occurred. Visual field abnormalities include paracentral scotoma, nasal scotoma, and arcuate scotoma. Patients may also have problems with depth perception and contrast sensitivity. Peripheral vision may worsen until the patient has tunnel vision and ultimately total field loss. Visual fields can be measured by perimetry and can detect defects in the visual field before a patient may notice.5,7

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