In glaucoma, which type of visual field loss is typically observed as the disease progresses?

• A. No visual field loss
• B. Progressive peripheral field loss
• C. Central vision loss first
• D. Bitemporal field loss

Answer: (B)

Glaucoma classically causes peripheral visual field loss that progresses over time. This pattern reflects the loss of retinal ganglion cells and thinning of the nerve fiber layer, producing arcuate (or wedge‑shaped) scotomas that hug the outer parts of the field while sparing the central fine detail. As damage advances, the peripheral field constricts further, eventually leading to tunnel vision in severe cases. Central vision tends to be preserved until late in the disease, so losing central vision first is not typical. Bitemporal field loss points to a lesion at or near the optic chiasm, not glaucoma, and no field loss would indicate a non-glaucomatous process.