Glaucoma is the name given to a group of eye diseases in which the optic nerve at the back of the eye is slowly destroyed. This results in loss of peripheral vision, leaving glaucoma sufferers with tunnel vision and eventually blindness if not treated. Glaucoma can be due to high pressure in the eye. Poor circulation to the optic nerve and structural weakness of the optic nerve can contribute to glaucoma developing where the eye pressure is normal. Reducing eye pressure in glaucoma patients can control glaucoma and help to prevent loss of peripheral vision.
Glaucoma is commonly referred to as the “sneak thief of sight”, because often there are no symptoms until permanent damage has occurred. Once vision is lost it is permanent, however early treatment can often prevent further loss so early detection is important. Left untreated glaucoma can lead to blindness.
There are 2 main types of glaucoma:
- Open-angle glaucoma
- Angle-closure glaucoma
What are the risk factors for glaucoma?
The exact cause for glaucoma is still unknown. Over 300,000 Australians have glaucoma and whilst anyone can get glaucoma, there are some specific risk factors for the disease.
- Elevated eye pressure
- Family history of glaucoma
- Some ethnic backgrounds
- Past eye injuries
- Prolonged use of cortisone medication (steroids)
- Systemic health problems including diabetes, high blood pressure and poor circulation.
Anyone in these higher risk groups should have their first eye check by the age of 35. For most people, it is recommended to have an eye check for glaucoma by the age of 40.
What are the symptoms of glaucoma?
The most common type of glaucoma is called open-angle glaucoma. It usually progresses slowly and can often go unnoticed for many months or years, causing a very gradual deterioration in peripheral (side) vision.
For angle-closure glaucoma the closing or narrowing of the drainage angle at the front of the eye can cause a sudden increase in eye pressure. This can cause symptoms including: pain in the eye, severe headache, nausea and vomiting and blurred vision. This type of glaucoma is serious and it can rapidly lead to blindness. It is important that you contact your ophthalmologist immediately if you notice any of these symptoms.
What are the treatment options for glaucoma?
Glaucoma is commonly controlled with eye drops taken daily. The drops can be varied to best suit the patient and reduce the pressure to a target pressure which will hopefully prevent any further damage to the optic nerve.
You should never change or stop taking your eye drops without advice from your ophthalmologist. Different drugs can interact, including eye drops, therefore it is important to make a list of all your medications and share this with each doctor you see.
Laser may be recommended for different types of glaucoma. In open angle glaucoma laser is used to modify the trabecular meshwork to improve fluid drainage and control eye pressure – this is called Selective Laser Trabeculoplasty (SLT).
In closed angle glaucoma, the laser creates a hole in the iris, (coloured part of our eye), to improve flow of the fluid to the front of the eye – this is called an iridotomy.
Should drops or laser treatment prove unsuccessful, it may be necessary to perform glaucoma drainage surgery. Your ophthalmologist will discuss this treatment option with you if it is required.
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