Glaucoma is a progressive degeneration of the optic nerve and is usually the result of raised eye pressure. The most common type of glaucoma is termed “primary open-angle” as there is no specific cause. There are also secondary causes of glaucoma. These include angle closure, trauma, and cataract, as well as other eye diseases.
What are the Symptoms of Glaucoma?
The main challenge of primary open-angle glaucoma is that there are often no symptoms early in the disease process. The peripheral vision is first affected. It may not be until in advanced disease that this loss is noticed. Unfortunately, once the vision has been lost it is not reversible. If left untreated, only the central vision remains. Eventually, this can also lead to blindness. Occasionally, patients may notice non-specific symptoms. These include headaches, tiredness of the eyes, haloes around lights at night, and patchy vision.
How is Glaucoma Diagnosed?
How is glaucoma diagnosed? It involves a detailed examination of the eye. When you are reviewed by your eye specialist, your vision will be tested along with intraocular pressures, field testing, and optic nerve assessment. Your optic nerve will also be scanned with an OCT. This can quantitate the degree of optic nerve damage and remaining nerve fibres. Additionally, it monitors the progression in quantitative terms.
What Are the Treatments For Glaucoma?
Most patients are treated using eye drops and / or SLT laser to lower the intraocular pressure as the first-line treatment. Sufficient lowering of the intraocular pressure is indicated to slow the progression of vision loss. If reasonable intraocular pressures are not achieved by medication and SLT laser, then surgery may be required. Such surgery includes a stent procedure, trabeculectomy, or tube drainage surgery. Stent surgery using MIGS devices has been a recent development with good results in minimally invasive glaucoma surgery. It may be combined with cataract surgery. Trabeculectomy or tube drainage surgery involves forming a new drainage to allow fluid to escape from the eye. This lowers the intraocular pressure. Medications may be used intraoperatively to augment the drainage procedure. The aim is to preserve functional vision for the lifetime of the patient.
Whilst glaucoma treatment and surgery are generally successful, there may be rare occasions when vision may be reduced due to the severity of the disease. Postop reviews will be required following any procedures, particularly to assess the intraocular pressure. Rare complications may include infection, retinal detachment, choroidal haemorrhage, or vision loss.
Do you have questions or concerns about your eye health or a specific eye condition? To discuss, please contact City Eye Centre for more information.