Glaucoma is a common condition which may occur at any age. It tends to occur more in middle aged and older patients. There are several different types of glaucoma, but they all share these features:
Gradual damage to the optic nerve, unless treated
Gradual damage to the peripheral vision of the affected eye/s, unless treated
Treatment is usually aimed at reducing the pressure inside the eyeball ("intraocular pressure") by medications, laser or surgery.
The problem is often asymptomatic (the patient cannot feel it) until late in the disease course
The ideal time to treat glaucoma is before the patient has any symptoms. Early detection is therefore important
How will I know if I have glaucoma?
Patients at risk should be examined by an ophthalmologist or an optometrist in order to look for signs of glaucoma.
Common risk factors for glaucoma:
Family history of glaucoma
Older age (over 40)
Short sightedness (myopia)
Significant far sightedness (hypermetropia)
Long term use of steroidal medications as eye drops or as tablets
Previous injury to the eye
Certain eye diseases which can be detected during routine examination (for instance pigment dispersion, pseudoexfoliation)
How can the specialist tell whether I have glaucoma?
The diagnosis of glaucoma requires examination of the eye and vision. The main factors considered are the anatomy of the front of the eye (anterior chamber), the intraocular pressure, and the optic nerve shape and function. There are various tests employed in order to obtain this information. The most common ones are clinical examination with a slit lamp, measurements of the intraocular pressure, observation of the optic nerve, testing the peripheral vision (computerised visual field testing) and scanning the optic nerve using OCT (optical coherence tomography) scanner. These tests are usually used repeatedly over the course of the disease, often for years.
I have been told I have glaucoma. What can be done about it?
Once the diagnosis of glaucoma is made, the goal of treatment is to stop or at least slow down the damage to the optic nerve. This is usually achieved by reduction of the intraocular pressure. In some patients the pressure is higher than normal to begin with, and in others the pressure is never above normal range, but regardless of that fact, the goal of treatment is to reduce the intraocular pressure to a level that will prove, over time, to be low enough to stop the disease progression.
Reducing the intraocular pressure can be achieved with the use of eye drops, or through invasive treatment with laser or surgery. The choice of treatment depends on the type of glaucoma and the patient’s medical profile, age and level of damage already caused to the optic nerve.
I have been told I have glaucoma. Does this mean I will go blind?
The vast majority of patients with chronic glaucoma maintain good vision for life with treatment. This is due to the improvements in early detection and treatment of glaucoma in the past few decades. So the answer to this question is usually “no”. However, in some patients glaucoma can lead to blindness, and glaucoma is still a leading cause of blindness in large populations around the world. In general, early detection and maintaining a good treatment and follow up routine reduce that risk to a very low level.