Glaucoma Information 

Glaucoma Treatment 

Glaucoma FAQs 


What is glaucoma? 

Glaucoma is a range of conditions that may cause damage to the nerve at the back of the eye, the optic nerve. Glaucoma is typically slow to progress but gets worse over time if untreated. Glaucoma is often, but not always associated with high pressure in the eye. If the disease progresses, the damage can cause blurriness or you may experience partial loss of vision, usually beginning with the side (peripheral) vision. The most extreme cases, if left untreated can cause tunnel vision and ultimately blindness. The only way we can manage glaucoma is to reduce the pressure in the eye. 

What are the signs of having glaucoma? 

Glaucoma will typically progress slowly over many years. Like most people with high pressure in the eyes (ocular hypertension) or glaucoma, you will most likely not notice anything at all. In the early stages your vision will be completely unaffected, and you will not notice any discomfort from the pressure. Occasionally, glaucoma may cause a rapid rise in eye pressure (this is known as acute angle-closure glaucoma) which will cause pain, redness, and blurred vision – but typically for most chronic glaucoma there is no pain at all. With more advanced glaucoma, you may notice subtle deterioration in your vision which can appear as blurred patches or parts missing from the vision. However, in the early stages the vision will not be affected. 
An optometrist, optician, eye surgeon or ophthalmologist would be able to tell you after an examination of the eyes that you have high intra-ocular pressure. However, a more thorough and complete examination is needed to diagnose glaucoma. This should include testing your field of vision with a ‘visual fields machine’ (an accurate test to see what you see with each eye), an evaluation of your optic nerve (both clinically and with an optical coherence tomography (OCT) scan and retinal nerve fibre analysis), and other tests. These are often repeated every 6-12 months to monitor for any signs of progression of the condition. 

Should people get treatment as soon as high eye pressure is noted? 

A thorough and comprehensive eye exam is needed, as well as a discussion about family history of glaucoma, general medical health, current medication, and allergies. It’s not always a question about whether to treat just because of raised eye pressure, but more an individual and holistic discussion and decision. For example, raised pressure (ocular hypertension) with no other signs of glaucoma can be treated with newer laser therapies (or example SLT laser) rather than regular eye drops. 
Sometimes ocular hypertension needs no treatment at all and simply requires regular follow-up appointments every 1-2 years. If glaucoma is progressing and affecting your vision or visual field, we may need to discuss further options such as additional drops, laser or other surgical options available to you. We want to offer you the treatment that’s right for you and we are happy to discuss all options in detail and answer any questions you might have. 

What are the main causes of glaucoma? Are there any other causes? 

Glaucoma does tend to run in families, which is why anyone over the age of 40 years who has a first degree relative with glaucoma can get free annual sight tests with their optician. Most glaucoma is a primary condition meaning there is no specific cause. There are many causes of secondary glaucoma, and we will always look for these – they may include previous inflammation, trauma, surgery or other conditions in the eye. They may include long-term use of steroids (creams, inhalers, tablets). Some medical conditions will be more likely lend themselves to certain types of glaucoma, and this includes diabetes. Glaucoma can also be congenital., Regardless of the cause, the main aim of treatment is uniform; that is to reduce the pressure in the eye. 

What’s the average age for glaucoma? 

For primary-open angle glaucoma, most of the people affected are over the age of 40 years. 

What types of glaucoma are there? 

Broadly speaking there are two types of glaucoma – open and closed-angle. Glaucoma can also be categorised as primary or secondary; and further categorised as acute or chronic. 
The aqueous fluid in the front of the eye drains where the outside edge of the coloured part of the eye (the iris) meets the clear cornea. This is called the ‘angle’. If this drainage angle is open and glaucoma develops, this is termed open-angle glaucoma. If the drainage angle is narrower or closed, then this may be termed angle-closure glaucoma. 
Glaucoma can also be seen as a spectrum: where at one end there is high pressure but no glaucoma (this is termed ‘ocular hypertension’), to early suspicion of signs of glaucoma (termed ‘glaucoma suspect’) to glaucoma. There are also some instances where the eye pressure is normal, but there are definitive signs of glaucoma or progression – this is termed ‘normal tension glaucoma’. 
We will always be happy to talk through all of this with you in clinic and answer any questions you might have. 
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