There are a number of people with glaucoma who are either new to diving or are old hats at diving, but new to the disease. Either way, the question as to whether or not they can dive with glaucoma is inevitably raised. Glaucoma is a disease of the eye that is not uncommon in people as they age. This is a condition that is brought on by increased pressure within the eye and this causes damage to the optic nerve and ultimately loss of vision occurs when left untreated. Because of the issue of increased pressure in the eye, many physicians have traditionally indicated that a high pressure environment, such as that which is experienced while diving, may not be good for those who suffer from glaucoma and that this might in fact increase the damage to the eye. However, despite these concerns, those who have gone diving with glaucoma have not suffered any ill effects.
The Divers Alert Network (DAN) states that it is not clear why those with glaucoma can dive safely, but it is suspected that the reason may be that the damage to the eye is actually caused by the pressure difference between the inside and outside of the eye, rather than simply the amount of pressure within the eye. So when a diver is underwater the pressure outside the eye is increased and that balances out the pressure on the inside of the eye, which does not lead to further damage. However, it is also important to realize that glaucoma can be developing for years without any signs or symptoms and vision can deteriorate during this time. For this reason, by the time the person notices symptoms of the disease it is relatively advanced and there is permanent damage to the vision. For this reason, everyone over the age of 40 should have regular checkups with their optometrist in order to catch the disease before it progresses too far.
Even though the disease itself causes no problems when diving, there are still a couple of concerns for those who are diving with glaucoma. One of these has to do with the medication that glaucoma patients take in order to lower the pressure within the eye. Medications such as Timolol can actually decrease the heart rate and this could put divers taking this type of medication at a higher risk for unconsciousness while diving. Other medications, such as acetazolomide might cause a tingling sensation in the hands and feet, which can be mistaken for decompression sickness. This can, in turn, cause panic and lead to other problems during a dive.
In addition to problems due to the medication that glaucoma patients receive, there are certain types of glaucoma surgery that might also affect a person when diving. These procedures are known as glaucoma filtering procedures and the goal of these procedures is to enable communication between the anterior chamber of the eye and the subconjunctival space in order to help reduce the pressure in the eye. If this procedure has been done on someone who dives, facemask barotrauma might cause this filter or communication to stop functioning properly and further damage to the eye might be the result. Additional eye surgery might also be required.
Of course, as glaucoma progresses and if it was left untreated for a period of time before diagnosis, there generally comes a point at which the person's vision is negatively affected. It is not the quality of the vision that is affected, but rather the field of vision, which will narrow progressively until it looks as though you are staring down the barrel of a gun. In these cases, when it comes to the point that the glaucoma causes poor vision, diving must stop. After all, if a diver cannot see well enough to read his or her watch or gauges, this is a serious danger.
As you can see, there are some concerns about diving with glaucoma, but these concerns are actually related to the treatment rather than the disease itself. If you have glaucoma and are taking medication or have undergone surgery for the condition, then you need to consult with your ophthalmologist before you dive so that you can be sure that you will be safe underwater. For those who have had eye surgery for glaucoma, a two month waiting period should be observed before returning to diving. Once you get the green light from your ophthalmologist, then you will be free to enjoy the wonderful sport of scuba diving and everything the underwater world holds for exploration.