Are visual field defects always present in patients with glaucoma?

Good question!: Glaucoma is a progressive optic neuropathy. What that means, is that it continues to get worse and cause more loss of vision. The visual field defects, once present, only continue to get worse. That is why the treatment is so important for holding on what you have.

No: Defects someone would notice in daily life would be late in the disease. Specialized visual field tests can show defects much sooner but still after damage has occurred. More specialized testing such as optical tomography can detect changes much sooner (ie, before visual field defects) and with appropriate treatment help preserve the vision.

No: Sometimes the elevated pressure will "eat away" at the myelin in the optic nerve causing an increase in the cup disc ratio before field damage occurs. This can give the patient a false sense of security and lead to noncompliance and subsequent damage.