Glaucoma
Glaucoma is a group of eye conditions that damage the optic nerve, which sits right at the back of the eye and sends visual information from your eye to your brain.
What is glaucoma?
Generally, glaucoma occurs when the pressure inside the eyeball becomes higher than it should be. This can happen suddenly or be more gradual. However, glaucoma can also occur with normal eye pressure. Concern about the diagnosis is usually identified by an optician and the diagnosis is confirmed and treated by an ophthalmologist.
Glaucoma is common in older adults, although it can occur at any age, including in infancy. Across the globe, it is the second leading cause of blindness after cataracts.
There are several different types of glaucoma depending on the underlying cause:
- chronic open-angle glaucoma or primary open-angle glaucoma
- primary closed-angle glaucoma
- normal-tension glaucoma
- congenital glaucoma
What causes glaucoma?
In most cases, glaucoma is caused by obstruction of the internal aqueous drainage system and subsequent damaging effects on the optic nerve.
However, the underlying cause of this blockage depends on the type of glaucoma you have:
- chronic open-angle glaucoma or primary open-angle glaucoma 鈥� this is the most common type of glaucoma. It develops slowly over several years and is partly due to the gradual blockage of tiny drainage channels that allow fluid to pass out of the eye to control eye pressure. Often, these blockages occur more frequently with age.
- primary angle closure glaucoma 鈥� this type of glaucoma develops due to the internal structures of the eye increasing the risk of elevated pressure. More rarely the closure can be 鈥榓cute鈥� leading to a more rapid 鈥榓ttack鈥� of glaucoma.
- normal-tension glaucoma 鈥� this type of glaucoma is a subset of primary open-angle glaucoma and occurs despite pressure in the eye being normal. The treatment options are very similar to primary open-angle glaucoma but your ophthalmologist will also discuss some other risk factors that need to be considered with this diagnosis.
- secondary glaucoma 鈥� this diagnosis of glaucoma is typically found when there has been some other eye disease (such as chronic inflammation) that predisposes the eye to glaucoma.
- congenital glaucoma 鈥� a child may be born with glaucoma or develop it in their first few years of life. So, congenital glaucoma is glaucoma diagnosed in a newborn or a child. It is caused by an underlying medical condition or injury which blocks drainage in the eye, causing pressure to build which damages the optic nerve.
Other than ageing, the risk factors for glaucoma include:
- a family history of glaucoma
- being of African, Hispanic or Asian heritage
- high blood pressure
- previous eye injury or surgery
- diabetes
- farsightedness or nearsightedness
- long-term use of steroid medications
- migraine
Glaucoma symptoms
Many people with glaucoma are not aware they have it, because, at first, there are no symptoms. Symptoms can come on very gradually, making them easy to miss.
When you do start to develop signs of the condition, they are likely to depend on the type of glaucoma you are experiencing. This means that your symptoms may be different to those affecting someone else who also has the condition.
The symptoms for each type of glaucoma include:
- gradually developing patchy blind spots in your peripheral vision
- reduced central vision
- headaches
- pain in your eye
- nausea or vomiting
- blurred vision
- rainbow-coloured halos or rings around lights
- red eyes
- gradual blurred vision
- reduced peripheral vision
- a dull or cloudy eye
- excessive blinking
- watery eyes or tears when not crying
- blurred vision
- progressive nearsightedness
- headaches
When to see a consultant?
Open-angle glaucoma may not cause any noticeable symptoms at all. Yet, the damage caused by glaucoma is irreversible.
Regular, annual eye exams with your optician are the safest way to make sure glaucoma is detected early and you can start treatment right away. This will reduce your risk of developing irreversible sight loss.
If you are experiencing symptoms then the glaucoma may be more advanced and you are recommended to see an eye doctor as soon as possible.
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Glaucoma treatments
The damage to your vision caused by glaucoma can鈥檛 be reversed. However, timely treatment can help to slow or prevent further loss of vision.
At AOA体育平台 Eye Centre, we have ophthalmologists trained in the latest techniques for treating glaucoma. These include SLT laser, minimally invasive glaucoma surgery, trabeculectomy and tube surgery.
The aim of treatment for glaucoma is to reduce pressure in the eye. However, there are different ways of doing this depending on the type of glaucoma you have. Some treatment plans may use a combination of treatment methods, depending on the type of glaucoma you have.
Find out more about possible treatments on our glaucoma treatment page.
- medicines 鈥� medicated eye drops are the most common treatment. However, oral medicines and injections can also be used. These lower the pressure in your eye
- laser treatment 鈥� laser treatment is a simple procedure that can help the fluid drain out of your eye
Your doctor may suggest surgery if medicines and laser treatment don鈥檛 work. There are different types of surgery that can help the fluid drain out of your eye.
One is laser surgery (peripheral iridotomy), during which a surgeon makes a new drainage channel in the iris for fluid in the eye to drain through and reduce the pressure in your eye. This procedure takes approximately 15鈥�20 minutes.
The other is glaucoma surgery, during which a surgeon makes a new drainage channel in the sclera (the white of your eyes) for fluid in the eye to drain through. This may be recommended if you鈥檝e tried other treatments and they haven鈥檛 worked. Glaucoma surgery is also normally the first port of call if you have acute angle closure glaucoma, as this is a medical emergency. The whole procedure takes between 45 and 75 minutes.
Both of these surgical treatments are day procedures, meaning you should be able to go home on the same day. They are often carried out under local anaesthetic, although glaucoma surgery can be performed under general anaesthetic.
