Functional disorders in the chronological progression of glaucoma

Abstract

Glaucomatous optic neuropathy is a complex process, which not only leads to destruction of the retinal ganglion cells but also negatively influences the third and fourth neurons. Therefore, in histological studies of glaucoma a significant cell loss in both the lateral geniculate nucleus and in the visual cortex could be detected. The involvement of the entire visual pathway in glaucoma leads to a variety of functional disturbances, which are presented in this overview. Besides the well-known visual field defects in glaucomatous optic neuropathy, additional disturbances occur in contrast sensitivity, color vision, stereo vision and increased sensitivity to glare. As a result, faces are less easily recognized , the reading speed is reduced, the location of objects is more complicated and the reaction rate decreases. All these alterations are increased with the progression of glaucomatous damage. The consequences of these visual impairments lead to an increasing social isolation and to an increased risk of falls and driving accidents, thereby significantly reducing the quality of life of glaucoma patients. Therefore, increasing awareness of these visual difficulties is necessary in the special care of patients with glaucoma and the domestic environment should be transformed accordingly.