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Glaucoma is a serious eye disease where progressive degeneration of the optic nerve results in gradual vision loss and it is usually the result of elevated eye (intraocular) pressure. Elevated eye pressure may occur due to a buildup of internal fluid (aqueous humor) that flows throughout the inside of the eye. This fluid normally drains out through the trabecular meshwork (the drainage channel of the eye). If the trabecular meshwork is not functioning properly or if there is an over-production of fluid, then an increase in eye pressure can occur.

EARLY DETECTION OF GLAUCOMA

Many people affected by glaucoma are not aware of any vision loss in the early stages of the disease. The loss of vision in glaucoma is usually gradual and peripheral (side) vision may be lost without prompt diagnosis and treatment. Once vision has been affected due to glaucoma, it cannot be recovered and “tunnel vision” at the end stage of glaucoma is commonly referred to. This is the reason why early detection is so important for protecting your sight. If glaucoma is detected and treated early, vision loss can be reduced or prevented.

WHAT ARE THE RISK FACTORS OF GLAUCOMA?

Age and family history are important risk factors of glaucoma. People over the age of 50 are at a greater risk of developing this eye disease and are encouraged to have eye examinations regularly. While glaucoma is more common as we get older, it is important to know that glaucoma can occur at any age. Anyone with a family history of glaucoma (especially in first-degree relatives) should have their eyes tested as there is a 10-fold risk of also developing the condition.

Risk factors of glaucoma include:

  • Age
  • Family history of glaucoma (especially first-degree relatives)
  • Medical conditions such as diabetes, hypertension, and heart disease
  • Being highly short-sighted or long-sighted
  • History of eye injuries or eye surgeries in the past
  • Taking medications such as corticosteroids including eyedrops

TYPES OF GLAUCOMA

Open-angle glaucoma

Open-angle glaucoma is the most common type of the disease. The drainage angle of the eye between the iris and the cornea is open but the trabecular meshwork may be partially blocked and not functioning properly. This results in an increase in eye pressure and progressive damage to the optic nerve.

Angle closure glaucoma

In angle closure glaucoma (also called closed-angle glaucoma), the drainage angle is closed, preventing the fluid to drain out of the eye resulting in an increase in eye pressure. The onset of angle closure glaucoma is usually sudden, and patients may experience symptoms such as severe headache, eye pain, blurred vision, eye redness, haloes around lights, vomiting and nausea. Acute angle-closure glaucoma is a medical emergency. If you experience any of the symptoms, you should be assessed and treated as soon as possible.

Normal tension glaucoma

Not all types of glaucoma are characterized by elevated eye pressures. In normal tension glaucoma, optic nerve may be progressively damaged even though the eye pressure is within a normal range. Causes may be due to limited blood supply or poor circulation and normal tension glaucoma needs to be appropriately managed.

HOW DO YOU TREAT GLAUCOMA?

Current glaucoma treatment works on the principles of enhancing the drainage of the fluid, reducing fluid production or bypassing the drainage system if it is obstructed. Depending on the type and stage of glaucoma, our doctors will advise the most appropriate treatment option following a comprehensive assessment. Investigations may include optic nerve analysis, corneal thickness and visual field testing.

Treatment options may include eyedrops, oral medications, laser treatment, eye surgery and minimally invasive glaucoma surgery (MIGS). MIGS involves small stent devices inserted in the eye to help drain the fluid to lower the pressure and/or reduce the need for glaucoma medications. Glaucoma surgery may involve making special drainage channels in the eye and sometimes using drainage tube devices in advanced cases.

MIGS are now commonly performed in combination with your cataract surgery or as a standalone procedure. A common question from patients who have had stents is:

Can I have an MRI if I have had MIGS due to the small device implanted inside the eye?

Two common MIGS devices are iStent inject® and Hydrus Microstent®. The Hydrus Microstent® is a tiny scaffold inserted into the natural drainage channel of your eye to lower the eye pressure and/or reduce the need for medications. The device is made of nickel-titanium (nitinol) alloy and should not cause an allergic reaction. It is considered safe if you need to have an MRI scan and the device will not set off airport scanners.

The iStent inject® device is currently one of the smallest medical devices known to be implanted in the human body. Constructed from heparin-coated titanium, the iStent inject® is designed to optimize the outflow of fluid in the eye to reduce pressure. Patients who have had iStent inject® can also undergo MRI scans safely if meeting the following conditions: static magnetic field of 3T or less. Please speak to our doctors if you have any concerns.

There are now proven treatments that will effectively slow or halt the progression of glaucoma. City Eye Centre specialises in the diagnosis and management of glaucoma, including evidence-based medical, laser and surgical treatment options. We ensure the best management through the most current research and practice.

Call our team today to learn more about glaucoma and treatments. We are conveniently located on Wickham Terrace, Brisbane and at the Specialist Medical Centre in Sunnybank. Phone (07) 3831 6888 to book your appointment or email appointments@cityeye.com.au

Do you know the symptoms and treatment options for cataracts?

Did you know that the origin of the name for the common eye condition ‘cataract’ is an ancient Greek word ‘katarrhaktēs’ meaning waterfall? A rapidly down-rushing waterfall appears white in colour so the word ‘cataract’ may have been used to describe the white appearance of a mature cataract in the eye.

What is a cataract?

A cataract is a cloudiness of the normally clear lens inside the eye. Most people over the age of 70 will have some form of cataract development. There are some factors which may hasten the speed to which cataracts develop and they include: increasing age, previous eye injury or surgery, diabetes, excessive UV exposure, use of steroids, being highly short-sighted, or having a family history of cataract.

While usually considered as a normal part of the ageing process, the clouding of the lens can result in blurred, distorted vision as well as increased sensitivity to glare. A lot of people describe vision similar to “looking through a dirty or foggy window”.  Some people may also experience double vision in one eye.

Symptoms from a developing cataract may include:

  • Blurred, hazy, distorted or foggy vision
  • Increasing difficulty with night time vision
  • Increased sensitivity to glare and bright light
  • Difficulty with reading, needing stronger light to read
  • Difficulty with driving, seeing haloes around car lights
  • Faded vision, objects appearing dim or yellowing
  • Frequent change of prescription in glasses
  • Double vision in a single eye

Cataracts usually develop slowly and may take years before it starts to affect your vision. When the cataract is mild, having better lighting and glasses may help you deal with the cataract. With time, the cataract may interfere with your daily activities and you may need to consider cataract surgery.

Is cataract surgery safe?

Cataract surgery is considered safe and effective. It’s commonly performed under monitored local anaesthesia as a day surgery procedure.

City Eye Centre is a leading specialist practice for cataract surgery in Brisbane. Our extensive expertise in this field is enhanced by our state-of-the-art technology and comprehensive pre-operative assessment. Understanding your lifestyle, what activities you enjoy doing, how you use your vision is also critical to the selection of the right intraocular lens type for you.

To optimise your recovery from cataract surgery, it’s important to follow some guidelines of eye care. Eye drops will be prescribed as part of the post-operative care to minimise risks of infection and control eye pressure and inflammation. It is important to avoid high impact exercise, swimming, and heavy lifting until your eye recovers. All our patients are closely monitored and we will address any concerns you may have during the recovery period.

Dr Lawrence Lee and his team at City Eye Centre offer extensive expertise in cataract surgery. Call us on (07) 3831 6888 to find out more or to book your next appointment.

Seeing Black Dots, Shadows, or Flashes?

Do you know the possible symptoms of retinal detachment? This serious eye condition requires urgent specialist retinal surgery — vitrectomy surgery and/or scleral buckle surgery — to increase the chance of successfully saving a patient’s sight.

Approximately one in ten thousand people may suffer from retinal detachment, with trauma, previous eye surgery, short-sightedness, or a family history of retinal detachment increasing the risks.

Retinal detachment is caused when the retinal lining detaches from the back wall of the eye due to a break or a tear. Fluid from the vitreous jelly leaks under the retina through the break or tear, which results in the retina detaching.

Symptoms may be sudden, and vision may be blurred. Some patients may see a red or pink tinge to their vision, due to the bleeding into the vitreous jelly.

Possible symptoms of retinal detachment can include:

  • Seeing black dots, floaters or ‘cobwebs’
  • Shadows or a curtain in your line of vision
  • Seeing flashes of light
  • Blurred vision or loss of vision
  • Vision may be tainted with a reddish or pinkish tinge
The retina can be seen to be detached from the underlying layers in bullous retinal detachment.
The retina can be seen to be detached from the underlying layers in bullous retinal detachment.

Requiring urgent treatment with micro-surgery using vitrectomy or scleral buckle surgery, patients with potential retinal detachment symptoms must be assessed and treated as soon as possible. Retinal detachment surgery may be a day or overnight procedure, usually performed under twilight sedation.

Dr Lawrence Lee at City Eye Centre is a specialist in this field and performs vitrectomy surgery at St Andrew’s War Memorial Hospital, Eyetech Day Surgery and the Royal Brisbane and Women’s Hospital.

Success rate for retinal detachment surgery depends on the severity of the condition and how long it has been present. Some patients may require further surgery if the retina fails to attach, due to scar formation on the retinal surface.

While vitrectomy is the primary method in reattaching the retina, this may be combined with scleral buckle surgery to reinforce the retina in certain types of retinal detachment to help close the breaks and improve the success rate.

Retinal detachment is often preceded by a retinal tear which can present as black dots in vision or flashes. If you suffer from these symptoms, please contact Dr Lawrence Lee’s practice on (07) 3831 6888 urgently. If these breaks or tears are detected, they may be successfully treated with laser surgery.

Are you seeing the signs of macular degeneration?

In the current climate, with growing uncertainty about COVID-19 and the vulnerability of the older population, it is understandable that people are wary about community transmission and have adapted accordingly to this new environment.

However, concerns about COVID aside, it’s still vital to remember that other health issues can still arise. It’s as important as ever to monitor your general and eye health and be on the lookout for any signs that may point to a potential problem.

Age-related macular degeneration is one of the leading causes of blindness in Australia. One in seven of people aged 50 and over may experience the signs of macular degeneration.

SYMPTOMS OF MACULAR DEGENERATION INCLUDE:

Blurred vision
Distorted vision
Wavy lines in vision
Grey patches in vision
Missing words or lines when reading

Macular degeneration affects your central vision; this means daily activities such as reading, knitting, seeing faces would be difficult. Your peripheral vision is usually not affected. There are different stages to macular degeneration: pigment changes and deposits at the macula in the early stage and there may be no loss of vision or symptoms. Intermediate and late stages of macular degeneration result in blurred and distorted vision and would require treatment.

Detecting macular degeneration as early as possible gives the patient the opportunity for a better response to treatment and success in maintaining vision.

City Eye Centre specializes in the treatments of macular degeneration utilizing intravitreal therapy with anti-vascular endothelial growth factor (anti-VEGF) agents. This treatment is very effective for the treatment of wet macular degeneration — slowing the disease and improving vision in 80% of patients. There is currently no specific treatment for dry macular degeneration.

We can also assist patients with dietary and lifestyle advice to improve their chances of slowing macular degeneration. This includes recommendations to select a diet high in anti-oxidants, nuts and green vegetables, and avoiding processed foods, margarine and cooking oils.

Smoking is also recognised as a key factor in the increased risk of macular degeneration.

Healthy diet for macular degeneration.

If you are concerned about your vision and the possibility of macular degeneration, make an appointment with our retinal specialist, Dr Lawrence Lee.

We specialise in the treatment of macular degeneration and offer a welcoming, COVID-safe environment for our patients.

Please ensure that you don’t attend our practice if you are unwell, and adhere to social distancing requirements and hand hygiene practices while you are at your appointment.

Let us look after your eye health and treat the signs of macular degeneration. Call our comprehensive ophthalmology specialist practice to book your appointment on (07) 3831 6888.