If you have routine examinations and you develop glaucoma, the chances of serious vision loss from glaucoma are very remote. However, late detection or non-compliance may result in vision loss. One may think of glaucoma being analogous to a house on the beach. If a house is in good shape and is hit by a series of storms, then the house will survive the storms with little damage (high eye pressure with a healthy nerve). However, if the foundation of the house has been damaged by previous storms there is a significant chance that the house will either be further damaged or swept away by the storm (a damaged nerve can not take the excess pressure from glaucoma). Thus, the key to preserving vision is early detection with aggressive treatment. The chronic, progressive nature of the disease makes it difficult for the patient to faithfully take their medication - the key to preserving vision.
Of 1259 cases of paediatric glaucoma presenting at our centre over 5 years, 59 children (%) were diagnosed with SIG. Of these, 51 (87%) had been prescribed topical steroids for vernal keratoconjunctivitis (VKC). The median duration of steroid use was 18 months (range 1 month to 8 years). Also, 82% of children with VKC had been prescribed steroids by the treating ophthalmologist and 52% had been on topical steroids for >1 year. Glaucomatous optic neuropathy was the cause of blindness in % (22/59) and low vision in % (14/59) children. And 27% (16/59) were unilaterally blind at presentation.