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Glaucoma: what the neurologist needs to know | Practical Neurology
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No commercial re-use. See rights and permissions. Published by BMJ." /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="Glaucoma is a progressive optic neuropathy resulting from pathological changes at the optic disc due to elevated intraocular pressure. Its diagnosis, treatment and follow-up are almost entirely conducted in ophthalmology clinics, with screening conducted by community optometrists. Despite this, neurologists may encounter glaucoma in both its acute presentation (as angle closure, presenting as acute headache) and its chronic forms (often as optic neuropathy of unknown cause). An awareness of the underlying pathological process, and the key distinguishing signs and symptoms, will allow neurologists to identify the glaucomatous process rapidly. Timely referral is essential as glaucoma invariably results in progressive visual loss without treatment. This review therefore condenses the wide field of glaucoma into a practical summary, aimed at practitioners with limited clinical experience of this ophthalmic condition. No data are available." /> <meta name="DC.Contributor" content="Gavin L Reynolds" /> <meta name="DC.Contributor" content="Gordon Plant" /> <meta name="DC.Contributor" content="Simon Epps" /> <meta name="DC.Contributor" content="Rani Sebastian" /> <meta name="DC.Contributor" content="Luke Bennetto" /> <meta name="article:published_time" content="2024-12-01" /> <meta name="article:section" content="What neurologists need to understand outside their own speciality" /> <meta name="citation_title" content="Glaucoma: what the neurologist needs to know" /> <meta name="citation_abstract" lang="en" content="<p>Glaucoma is a progressive optic neuropathy resulting from pathological changes at the optic disc due to elevated intraocular pressure. Its diagnosis, treatment and follow-up are almost entirely conducted in ophthalmology clinics, with screening conducted by community optometrists. Despite this, neurologists may encounter glaucoma in both its acute presentation (as angle closure, presenting as acute headache) and its chronic forms (often as optic neuropathy of unknown cause). An awareness of the underlying pathological process, and the key distinguishing signs and symptoms, will allow neurologists to identify the glaucomatous process rapidly. Timely referral is essential as glaucoma invariably results in progressive visual loss without treatment. This review therefore condenses the wide field of glaucoma into a practical summary, aimed at practitioners with limited clinical experience of this ophthalmic condition.</p>" /> <meta name="citation_journal_title" content="Practical Neurology" /> <meta name="citation_publisher" content="BMJ Publishing Group Ltd" /> <meta name="citation_publication_date" content="2024/12/01" /> <meta name="citation_mjid" content="practneurol;24/6/493" /> <meta name="citation_id" content="24/6/493" /> <meta name="citation_public_url" content="https://pn.bmj.com/content/24/6/493" /> <meta name="citation_abstract_html_url" content="https://pn.bmj.com/content/24/6/493.abstract" /> <meta name="citation_full_html_url" content="https://pn.bmj.com/content/24/6/493.full" /> <meta name="citation_pdf_url" content="https://pn.bmj.com/content/practneurol/24/6/493.full.pdf" /> <meta name="citation_issn" content="1474-7758" /> <meta name="citation_issn" content="1474-7766" /> <meta name="citation_doi" content="10.1136/pn-2023-003905" /> <meta name="citation_pmid" content="38906698" /> <meta name="citation_volume" content="24" /> <meta name="citation_issue" content="6" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="What neurologists need to understand outside their own speciality" /> <meta name="citation_firstpage" content="493" /> <meta name="citation_lastpage" content="502" /> <meta name="citation_author" content="Gavin L Reynolds" /> <meta name="citation_author_institution" content="University Hospitals Bristol and Weston NHS Foundation Trust" /> <meta name="citation_author_institution" content="Bristol Eye Hospital" /> <meta name="citation_author" content="Gordon Plant" /> <meta name="citation_author_institution" content="National Hospital for Neurology and Neurosurgery" /> <meta name="citation_author" content="Simon Epps" /> <meta name="citation_author_institution" content="University Hospitals Bristol and Weston NHS Foundation Trust" /> <meta name="citation_author_institution" content="Bristol Eye Hospital" /> <meta name="citation_author" content="Rani Sebastian" /> <meta name="citation_author_institution" content="University Hospitals Bristol and Weston NHS Foundation Trust" /> <meta name="citation_author_institution" content="Bristol Eye Hospital" /> <meta name="citation_author" content="Luke Bennetto" /> <meta name="citation_author_institution" content="University Hospitals Bristol and Weston NHS Foundation Trust" /> <meta name="citation_author_institution" content="Bristol Eye Hospital" /> <meta name="citation_author_institution" content="Department of Neuroscience" /> <meta name="citation_author_institution" content="North Bristol NHS Trust Southmead Hospital" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0002-5024-3567" /> <meta name="citation_reference" content="citation_journal_title=BMJ;citation_title=Glaucoma and intraocular pressure in EPIC-Norfolk eye study: cross sectional study;citation_volume=358;citation_year=2017" /> <meta name="citation_reference" content="citation_journal_title=Eye;citation_author=A. 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Its diagnosis, treatment and follow-up are almost entirely conducted in ophthalmology clinics, with screening conducted by community optometrists. Despite this, neurologists may encounter glaucoma in both its acute presentation (as angle closure, presenting as acute headache) and its chronic forms (often as optic neuropathy of unknown cause). An awareness of the underlying pathological process, and the key distinguishing signs and symptoms, will allow neurologists to identify the glaucomatous process rapidly. Timely referral is essential as glaucoma invariably results in progressive visual loss without treatment. This review therefore condenses the wide field of glaucoma into a practical summary, aimed at practitioners with limited clinical experience of this ophthalmic condition. No data are available." /> <meta name="og-title" property="og:title" content="Glaucoma: what the neurologist needs to know" /> <meta name="og-url" property="og:url" content="https://pn.bmj.com/content/24/6/493" /> <meta name="og-site-name" property="og:site_name" content="Practical Neurology" /> <meta name="og-description" property="og:description" content="Glaucoma is a progressive optic neuropathy resulting from pathological changes at the optic disc due to elevated intraocular pressure. Its diagnosis, treatment and follow-up are almost entirely conducted in ophthalmology clinics, with screening conducted by community optometrists. Despite this, neurologists may encounter glaucoma in both its acute presentation (as angle closure, presenting as acute headache) and its chronic forms (often as optic neuropathy of unknown cause). An awareness of the underlying pathological process, and the key distinguishing signs and symptoms, will allow neurologists to identify the glaucomatous process rapidly. Timely referral is essential as glaucoma invariably results in progressive visual loss without treatment. This review therefore condenses the wide field of glaucoma into a practical summary, aimed at practitioners with limited clinical experience of this ophthalmic condition. 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class="panel-pane pane-highwire-article-citation col-mobile-10 col-narrow-10 col-normal-11 article-title" > <div class="pane-content"> <div class="highwire-article-citation highwire-citation-type-highwire-article node152568" data-node-nid="152568" id="node-152568--22082423055" data-pisa="practneurol;24/6/493" data-pisa-master="practneurol;pn-2023-003905" data-apath="/practneurol/24/6/493.atom"><cite class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Glaucoma: what the neurologist needs to know</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="practneurol;pn-2023-003905" data-atom-uri="/practneurol/24/6/493.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://pn.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">Gavin L Reynolds</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">1</a>, </li><li class="contributor" id="contrib-2"><span class="name">Gordon Plant</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">2</a>, </li><li class="contributor" id="contrib-3"><span class="name">Simon Epps</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">1</a>, </li><li class="contributor" id="contrib-4"><span class="name">Rani Sebastian</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">1</a>, </li><li class="last" id="contrib-5"><a href="http://orcid.org/0000-0002-5024-3567" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0002-5024-3567</a><span class="name">Luke Bennetto</span><a id="xref-aff-1-4" class="xref-aff" href="#aff-1">1</a><span class="xref-sep">,</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">3</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address> <sup>1</sup> <span class="institution">University Hospitals Bristol and Weston NHS Foundation Trust</span>, <span class="institution">Bristol Eye Hospital</span>, <span class="addr-line">Bristol</span>, UK </address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address> <sup>2</sup> <span class="institution">National Hospital for Neurology and Neurosurgery</span>, <span class="addr-line">London</span>, UK </address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address> <sup>3</sup> <span class="institution">Department of Neuroscience</span>, <span class="institution">North Bristol NHS Trust Southmead Hospital</span>, <span class="addr-line">Bristol</span>, UK </address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Dr Gavin L Reynolds; <span class="em-link"><span class="em-addr">gavin.reynolds{at}doctors.org.uk</span></span> </li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><p id="p-1">Glaucoma is a progressive optic neuropathy resulting from pathological changes at the optic disc due to elevated intraocular pressure. Its diagnosis, treatment and follow-up are almost entirely conducted in ophthalmology clinics, with screening conducted by community optometrists. Despite this, neurologists may encounter glaucoma in both its acute presentation (as angle closure, presenting as acute headache) and its chronic forms (often as optic neuropathy of unknown cause). An awareness of the underlying pathological process, and the key distinguishing signs and symptoms, will allow neurologists to identify the glaucomatous process rapidly. Timely referral is essential as glaucoma invariably results in progressive visual loss without treatment. This review therefore condenses the wide field of glaucoma into a practical summary, aimed at practitioners with limited clinical experience of this ophthalmic condition.</p></div><ul class="kwd-group"><li class="kwd">OPHTHALMOLOGY</li><li class="kwd">NEUROOPHTHALMOLOGY</li><li class="kwd">NEUROPATHOLOGY</li><li class="kwd">HEADACHE</li><li class="kwd">VISION</li></ul><div class="section data-availability" id="sec-10"><h2 class="">Data availability statement</h2><p id="p-50">No data are available.</p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane oas-ads oas-ads-mid pull-right" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/pn-2023-003905" target="_new">https://doi.org/10.1136/pn-2023-003905</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/pn-2023-003905" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. 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GP, SE and RS provided review and editing. LB provided review, editing and final overview.</p></li><li class="fn-other" id="fn-3"><p id="p-47"><span class="fn-label">Funding</span> The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.</p></li><li class="fn-conflict" id="fn-4"><p id="p-48"><span class="fn-label">Competing interests</span> None declared.</p></li><li class="fn-other" id="fn-5"><p id="p-49"><span class="fn-label">Provenance and peer review</span> Commissioned. 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