CUP OF AMAUROSIS - A CUP BRIMMING WITH GLOOM

The bliss of sight indeed so divine, ask any blind person
Routes of losing that, are many, they surely ensemble,
This silent killer has the longest name in ocular jargon,
Glaucoma, its abridged sobriquet, is chronically simple.

Open angle, yet the meshwork is adamant in resistance,
Racial, genetic, extracellular matrix, or vascular reasons,
Mechanical pinching of axons at the laminar dehiscence
Opti neurons sans work or induced apoptosis beckons.

Net reduction in aqueous outflow bears the total insult
Triad of things to look and search for nailing its name.
Optic discs, visual fields first, visual loss, the end result,
Intraocular tension, elevation not in all testing frame.

Vagaries of disc often bemusing, needs close attention
Large disc, in depth, vertical length, and laminar dots,
Asymmetry, neural rim, artery pulsations in pretension,
Pallor, saucerised, bayonetting, or the splinter red spots.

Summing up the damage, axonal demise slowly creep,
Field changes follow invariably, uninvited and ensure,
Scotomas, paracentral, Siedels, double arcuates sweep,
Residual tiny islands of vision, then amaurosis for sure,
 
Why this silent sabotage? We the oculist grope in dark,
Let those triad surround every hill of vision in duress,
Lead a new light in the tunnel, be it our motto and task,
If not, in shame let us too drown in the sea of darkness.