Keeping an eye on glaucoma

We hear a lot more about glaucoma these days and often it is in connection with fund raising for overseas – glaucoma is more common in certain communities such as those in West Africa and the Caribbean.

But glaucoma is also reasonably common in the UK – statistics show that around 5% of people over the age of 65 are affected by this condition. It also runs in some families and not in others and being very shortsighted can also sometimes make one vulnerable to the disease.

Either way, it is a nasty problem to encounter and it is actually the leading cause of blindness in the world.

Glaucoma is a disease of the optic nerve which is the major nerve of vision. This nerve receives the light-generated nerve impulses from the retina and transmits them over to the brain where they create the vision we know and recognise. One of the main causes of glaucoma is raised pressure in the eye and this is why older patients at least usually have their eye pressure tested automatically when they visit their optometrist.

If you are suffering from glaucoma, you may not initially notice there is anything wrong. This is because this disease affects the outside, or the peripheral, field of your vision first. Therefore you can still read and see straight ahead, and you may not be aware of the problem until your sight begins to deteriorate quite severely.

Glaucoma may be picked up by your optometrist before you realise you have the problem, or you may make an appointment because you are worried.

Either way, today an optometrist has excellent ways to determine whether you are suffering from the disease. He will look at your optic nerve with a special light and examine the thickness of your cornea. He will also measure the pressure in your eye using what is known as a tonometry test; and he may also run a perimetry test which will measure your field of vision by showing a sequence of spots of light on a screen and checking which ones you can see.

The next step, if you may have the disease, is to visit an ophthalmologist for further tests. These can include a gonioscopy test to examine the drainage of your eye.

Treatment will depend on how much the disease has progressed.
Treatment for glaucoma aims to lower the pressure inside your eye to reduce the risk of future sight loss if it hasn't already deteriorated, or prevent any further loss of sight. Treatment can't reverse any existing optic nerve damage, so it won't improve your sight if it has already deteriorated.

Medication such as eye drops and tablets are often a starting point to help ensure the eye is draining well and to reduce the pressure in the eye.

Laser treatment is sometimes used to widen the holes in the draining system in the eye to help ensure adequate drainage to the eye.

There is also a range of operations that can be undertaken to reduce the pressure in the eye, including a traveculectomy when a tiny opening is created in the eye wall to allow fluid to escape. Sometimes this can be done under local anaesthesia.
It is important to know that once the optic nerve has been damaged, it can’t be improved by treatment. All medication can do is halt any further deterioration.

Also, for various reasons, occasionally acute glaucoma can come on very quickly. The symptoms include blurred vision or a halo around lights, loss of sight, feeling sick or experiencing redness in the whites of your eyes. If you feel you have this problem, it is very important to obtain professional medical advice as a matter of real urgency.

In the UK, thanks to the level of checks undertaken by optometrists, glaucoma is often identified in good time. However, eye problems should never be ignored and certainly with glaucoma, speed of treatment can make all the difference. If you think you have eye problems, make an appointment with your optometrist immediately.

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