Having that very first diagnosis, receiving "emergency" medications, and that night driving directly to the hospital the process begins. The tablets given to me by my doctor I later learned that it was Acetazolamide, sold under the trade name Diamox and is a medication used to treat high interoccular pressure, epilepsy, acute mountain sickness, periodic paralysis, idiopathic intracranial hypertension (raised brain pressure of unclear cause), heart failure and to alkalinize urine. I guess I should have been thankful that all those things were now controlled, but given I only had one of them that I knew of, and that the medication has some unpleasant side effects, I didn't feel particularly thankful.

So here is the world that you now enter. One of sitting up to one of these quite amazing instruments where these amazing medical people can see right into the inner chanber of your eyes and see just what is going on. Not that everything going on there is fully understood, but at least most things are described and have proven treatments to control symptoms and to help minimize damage to the optic nerve in many cases.

But it sure is not comfortable. Rather like a trip to the dentist, except that with this ongoing threat of glaucoma there is no end in sight as there would be with a dentist who mostly repairs damage and you move on.

I was diagnosed in 1987 and from that time until I moved to South East Asia in 2001, I was treated at the Princess Alexandra Hospital in Brisbane. This is a public hospital, in Australia at that time, all treatment was free and of a very high standard. Of course, with this type of system, it becomes something of a sausage factory where I am given an appointment to see the doctor at 2pm on the appointment day. I dutifully turn up at about 1:30 pm only to find that there are at least 80 other people all with a appointment for the same doctor at 2pm. Rows of pews are set up outside the treatment rooms, and you took your place as the "next in line" in the pews. When the person in the gun position got up and went in to see the doctor, everyone shuffled down another place. Finally after hours of sitting in a large,stuffyl and very crowded waiting room, you find yourself in the gun postion so that when that buzzer sounded for you, you were up and in to receive your evaluation and next step in the treatment process.

Now I studied all this glaucoma stuff once it was a big thing in my life now, so I knew a thing or three about it, probably just enough to be dangerous, but would ask the doctor a lot of questions. In those days, patients wanting to know more about their condition were just being a nuisance. When I asked the doctor what the IOP readings actually were, he just looked at me and couldn't figure out what business was that of mine. He was the doctor, he would do the doctoring, and I would receive my medications and instructions and be shown the door.

Treatment went on with eye drops prescribed that I was to obediently use through to the next appointed evaluation day. These were usually about 6 weeks apart. What I know now is that my condition was sporadic, that is, I could be normal IOP for a week, then have an episode of super high IOP for a few days, then back to normal. Doctors were not interested to hear my stories and anecdotes of what was happening. They only considered what they observed on the day, administered the recommended treatment, and showed me the door while hitting the buzzer for the next patient to come in.

Finally, after about a year of back and forth, Interoccular Pressure readings in my right eye (left eye was not affected in these early years) it was decided that a procedure called a Trabeculectomy should be performed.

At this time (late 1980s Australia) the procedure was well known, performed often, and results were predictable. There were some issues that later surfaced, but for the day to day treatment of my condition, this procedure was successful.

However, such a procedure doesn't last forever. The process of creating a vent in the eye surface to releive the pressure will ultimately heal over, thus negating the whole process and you will be right back where you started from.

Carry on reading the articles to find out how I have now gone through 3 of such trabeculectomies as well as two lazer processes hopefully attempting to get similar results without the full invasive surgery (neither of which worked) one remedial process where an old trabeculectomy site is "needled" to make it work again (turned out to be somewhat dangerous, I will post that story later) and as I write this, am about to have yet another operation on my right eye in the next week or so - stay tuned.