Glaucoma

Symptoms?

The most common types of glaucoma have completely different symptoms.
Patients with primary open-angle glaucoma may notice the following symptoms:

• Gradual loss of peripheral vision, usually in both eyes
• Tunnel vision in the advanced stages

While patients with acute angle-closure glaucoma will notice the following symptoms:

• Eye pain
• Nausea and vomiting (accompanying the severe eye pain)
• Sudden onset of visual disturbance, often in low light
• Blurred vision
• Halos around lights
• Reddening of the eye

Risk factors for Glaucoma include:

• Elevated intra-ocular pressure
• Aged 60 or over
• Family history of glaucoma – Having a family history of glaucoma means you have a greater risk.
• Medical conditions. Some conditions may increase your risk. (Diabetes, Heart diseases, Hypertension and Hypothyroidism).
• Co-existing eye conditions. Various eye conditions increase a patient’s risk. (Severe eye, Eye tumours, Retinal detachment, Eye inflammation and lens dislocation).
• Long-term corticosteroid use – Using corticosteroid medications (especially eye drops) chronically can increase your risk.

Diagnosis?

Tests that can be performed to diagnose Glaucoma include:

• Intraocular pressure checks – This is a simple, painless procedure that measures your internal eye pressure.
• Optic Nerve Examination – This is a check for damage in the optic nerve. Various uses instruments can be used and they look directly through the pupil to the back of the eye.
• Visual Field Test – This checks for visual field loss which has been caused by glaucoma. Specialised machines are used to test a patient’s visual field.
• Gonioscopy – Used to distinguish between open-angle glaucoma and angle-closure glaucoma. A special lens is placed on the eye to inspect the drainage angle.

Treatment?

The goal of treatment is to lower intraocular pressure. Depending on the condition, ophthalmologists will aim to lower eye pressure, improve drainage of fluid or lower the amount of fluid produced.

Treatment and regular appointments can prevent visual loss. If vision loss has already occurred, treatment can slow or prevent further vision loss.

Eye Drops

Glaucoma treatment generally commences with medicated eye drops. It is important use the drops exactly as prescribed.

Oral medications

If eye drops alone don’t reduce the eye pressure to the desired level, the doctor may prescribe an oral medication.

Surgery

Surgery can be utilized to treat Glaucoma if the patient is in-tolerant to medications or if they’re ineffective. A single surgical procedure may not effectively lower the intra-ocular pressure eye pressure. Continuation of eye drops or combination of surgical intervention may be needed.

Surgeries that may be performed to treat glaucoma include:

• Laser Trabeculoplasty
  A procedure to treat open-angle glaucoma. The doctor uses a high-energy laser beam to open clogged drainage canals which helps fluid drain more easily from your eye.
• Trabeculectomy
  This procedure is performed in a day surgery or hospital. The retinal specialist will use small instruments to create an opening in the sclera. This allows the removal of a small piece of eye tissue so fluid can drain through the eye.
• Drainage Implants
  This surgery involves the insertion of a small tube in the eye to facilitate draining fluid to reduce the eye pressure.

Treating acute angle-closure glaucoma

Acute angle-closure glaucoma is a medical emergency. When diagnosed, urgent treatment is required to reduce the pressure. This will require both medication and laser surgery. A laser peripheral iridotomy is used to create a small hole in your iris. This allows the fluid to flow through the eye.