Glaucoma
Glaucoma is one of the leading cause of blindness worldwide. If glaucoma is diagnosed early, vision loss can be slowed or prevented. If you have been diagnosed with the condition, you will generally need treatment for the rest of your life.
What is glaucoma?
Glaucoma is a group of eye conditions that damage the optic nerve, which is crucial to good vision. This damage is often caused by an abnormally high pressure in the eye. Vision loss due to glaucoma is permanent, therefore it is important to have regular eye exams that include measurements of your eye pressure.
Types of Glaucoma
Glaucoma can be categorized as follows:
- Open Angle Glaucoma - is the most common which usually has no warning signs. The effect is so gradual that patients may not notice a change in vision until the condition is at an advanced stage.
- Closed Angle Glaucoma
Who is at Risk of Glaucoma?
It can occur at any age but is more common in middle aged people. Some people have a higher than normal risk of getting glaucoma. This includes people who:
- Age 40 or over
- Have family history of glaucoma
- Have high eye pressure
- Are of African or Hispanic heritage
- Are farsighted (Hyperopia) or nearsighted (Myopia)
- Have corneas that are thin in the centre
- Have diabetes, migraines, poor blood circulation or other general health problems that affect the eye
- Have had an eye injury
People with more than one of the above risk factors have an even higher risk of glaucoma, and they should consult an ophthalmologist at the age of 40 for a comprehensive eye examination.
Acute Angle-Closure Glaucoma
This is an eye emergency, which requires immediate medical attention and treatment. Patients may complain of the following symptoms:
- Severe headache
- Eye pain
- Nausea and vomiting
- Blurred vision
- Halos around lights
- Eye redness
It is very important for patients with the above symptoms to seek urgent medical attention as they need urgent medical treatment to lower their eye pressure.
How is glaucoma diagnosed?
Open-angle glaucoma gives few warning signs (patchy blind spots in peripheral or central vision) until permanent damage has already occurred. Regular eye examination is the key to detecting glaucoma early enough to successfully slow or prevent vision loss.
As mentioned, people with any risk factors of glaucoma should have:
- A comprehensive eye examination
- Eye pressure measurement
- Gonioscopy (assessing the anterior chamber drainage pathway)
- Dilated fundus examination
- Imaging of optic nerve head
- Visual field test
Sometimes, patients may be identified as glaucoma suspects through a routine eye examination with an optometrist.
It is important to maintain regular follow up with your ophthalmologist once a diagnosis of glaucoma is made.
What are the current treatment options for glaucoma?
Eye Drops
At the early stage of the disease, patients can usually be managed medically with eye drops that lower the eye pressure. It is important to consult an ophthalmologist regarding the eye drops as some of them have significant side effects.
Selective Laser Trabeculoplasty or SLT
Alternatively, your ophthalmologist may offer a laser treatment (Selective Laser Trabeculoplasty or SLT) which can lower the eye pressure by increasing the drainage of fluid in your eye.
Minimally Invasive Glaucoma Surgery or MIGS
Recently, a new surgical treatment has been introduced, which involves insertion of microstents into the drainage angle of the eye during cataract surgery (Minimally Invasive Glaucoma Surgery or MIGS). This procedure has been shown to reduce eye pressure and is very safe and it may allow patients to reduce the number of their anti-glaucoma eye drops.
Trabeculectomy or Tube Shunt
These procedures are reserved for patients who have been treated with maximum medical therapy and their eye pressures remain high. Glaucoma drainage surgery (trabeculectomy or tube shunt) is very effective in lowering the eye pressure, which in turn halting the consequential damage of the optic nerve caused by the disease.
