Glaucoma

What is Glaucoma?

Glaucoma is a group of conditions which involve an increase of the pressure inside the eye. Increased intraocular pressure (IOP) can often result in damage to the optic nerve and the loss of peripheral vision.

Different types of glaucoma can require different treatments. The danger with glaucoma is that there can be significant damage taking place but as there is no pain and the eyes feel normal you will probably be unaware that there is a problem until significant amount of peripheral vision is permanently lost.
Early detection and subsequent treatment is therefore vital if sight loss is to be avoided.

Who is at risk?

1 in 200 people in the U.K.

  • If you have a direct relative who has glaucoma then your risk of having the diseases is increased by 10%.
  • If your Intra Ocular Pressure (IOP) is greater than 22mmHg you are more likely to have glaucoma. IOP should be measured during a routine eye examination by your optometrist.
  • The risk of glaucoma varies between ethnic origins. Black and Asian populations have a higher incidence of glaucoma compared to Caucasians.
  • As you get older the risks of suffering from glaucoma increases.
  • Evidence shows that patients who have suffered certain eye complications such as central retinal vein occlusion, retinal detachment, Fuch’s endothelial dystrophy and retinitis pigmentosa have a higher incidence of glaucoma.

Detection

Glaucoma is a sight threatening disease which if untreated will get progressively worse, so early detection is vitally important. Regular eye examinations, especially for those over 40 years old are sensible. Prevention is better than cure!

When performing an eye examination your optician will analysis the appearance of your optic nerve at the back of your eye. The pressure in the eye will be measured and a visual field test performed to check your peripheral vision.

The problem with relying on these test is that you have to already have a problem (such as part of your visual field being defective) before a diagnosis can be made.

Unlike many optical practices The Medical Eye Clinic uses a technique known as Ocular Coherence Tomography (OCT) which is able to analyse the optic nerve and can detect this sight-threatening disease at a much earlier stage. OCT is an advanced eye scan which uses light to illustrate the different layers of the eye. The scan is non-invasive, simple and painless. The information it gives us is invaluable and for many patients can be used to help predict if a future glaucoma problem is likely.

Glaucoma Treatment

Glaucoma management is a lifelong process that requires frequent monitoring and constant treatment. At the Medical Eye Clinic, we offer a range of treatments all of which are designed to reduce the IOP which is at present the only way to manage the disease. Our Glaucoma Consultant will tailor a treatment plan to your individual needs.

Glaucoma Eye Drops

Traditionally glaucoma eye drops have been the first choice of treatment and they can be very effective. These drops need to be instilled on a regular basis, often daily. Some people are not comfortable instilling eye drops every day and there are certain medical conditions that can make you are a poor candidate for glaucoma eye drops. Fortunately, at The Medical Eye Clinic drops are not the only treatment.

LASER TREATMENT – Selective Laser Trabeculoplasty or SLT

SLT is a simple and safe procedure that effectively reduces the intra ocular pressure in many glaucoma patients. The laser is applied to the structure within the eye that is responsible for drainage and this reduces the pressure within the eye.

Before the procedure a few drop of aesthetic is instilled to ensure the eye remains comfortable throughout. You would not be able to drive immediately after the procedure however by the following day driving should be possible.

Your eyes may become a little light sensitive for a week and in some cases, this may be severe enough to warrant treatment with anti­-inflammatory drops.
Approximately 3% of patients can experience a significant increase in pressure immediately following laser treatment however this returns to normal in almost all cases.

SLT is effective in about 80% of glaucoma cases. It often takes a few weeks to achieve the full response to the treatment but the resultant IOP is usually stable for a number of years negating the need to constantly instil eye drops.

Regular appointments using OCT, visual field analysis and IOP measuring will be used to monitor the results and when required the procedure can be repeated

Written by - Mr Charles P Bill BSc MC Optom