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Glaucoma is a progressive eye condition with increasing damage to the optic nerve causing in loss of visual field (peripheral vision loss). Over time, progressive damage causes more vision to be lost and leading to blindness.
Vision lost by glaucoma and damage to the optic nerve cannot be recovered. So it’s essential to diagnose it early and monitor it carefully to prevent as much vision loss as possible.
Mostly, glaucoma tends to develop slowly over many years, and normally affects peripheral vision first, causing ‘tunnel vision’. If untreated, it can cause blindness.
Very occasionally, the eye pressure can become raised suddenly and cause severe eye pain, redness and loss of sight. If this is not treated within 3 to 48 hours, eye sight can be lost and permanent blindness can ensue.
In the UK, most patients are usually referred to the hospital or their eye surgeon by their high street optician.
Successful management of glaucoma relies on early diagnosis and careful monitoring of patients.
90% of treated patients do not go blind and hence it is important to seek treatment.
Diagnosis
Glaucoma is diagnosed by ophthalmologists or eye surgeons. Usually, 2 out of 3 tests signify glaucoma. These include intraocular pressure measurement, optic disc assessment and visual field assessment. Other tests in use are optic nerve OCT, corneal thickness ultrasound, gonioscopy and anterior segment imaging.
Tests
Regular tests to monitor glaucoma progression are usually required.
These include
1. Intraocular pressure measurements
2. Sequential Visual field analysis over time
3. Optic nerve assessments/ nerve fibre layer analysis over tim
Treatment
Treatment usually involves eye drops in the first instance. The eye drops are usually life long unless specified otherwise by the eye doctor. Few people may not be able to tolerate eye drops due to side effects like allergies, breathlessness, inflammation or other issues.
In some patients the eye drops may not work and the pressure of the eye remains raised causing more damage to the eye.
In such patients, eye surgery may be considered.
Eye surgery has its own risks and benefits. In some patients, eye surgery can get rid of the need of life long glaucoma medication. In other patients , reduction in the eye drops can be achieved. The aim of surgery is to keep the pressure of the eye low enough to prevent accelerated vision loss due to glaucoma.
Mr Saeed treats glaucoma with drops , lasers ( laser iridotomy) and istents with cataract surgery. This depends on the type and severity of glaucoma. Optimization and personalization of the treatment plan is the goal to avoid / prevent vision loss.
