Glaucoma is a group of diseases that damages the eye’s optic nerve usually caused by raised pressure within the eye. If left untreated, it can cause blindness. Glaucoma usually develops without early symptoms and progress slowly.
Detection requires regular screening and monitoring by an optometrist or ophthalmologist and early referral for diagnosis and treatment to prevent deterioration and loss of vision.
The most common form of glaucoma is called primary open-angle glaucoma. It occurs when the drainage meshwork of the eye gradually becomes less efficient at draining fluid. As this occurs, your eye pressure, also called intraocular pressure (IOP), rises. Raised eye pressure leads to damage of the optic nerve. Damage to the optic nerve can occur at different eye pressures among different patients. Your ophthalmologist may establishe a target eye pressure for you that he or she predicts will protect your optic nerve from further damage. Different patients have different target pressures.
Typically, open-angle glaucoma has no symptoms in its early stages and your vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision.
Closed Angle Glaucoma
A less common form of glaucoma is closed-angle, or narrow-angle, glaucoma. Closed-angle glaucoma occurs when the drainage angle of the eye becomes blocked. Unlike open-angle glaucoma, eye pressure usually goes up very fast.
Normal Tension Glaucoma
Although normal eye pressure is consider a measurement under 21mm Hg, this can be misleading. In those who have a type of glaucoma called normal-tension, or low-tension, glaucoma, their eye pressure is consistently below 21mm Hg but optic nerve damage and visual field loss still occur.
People with normal-tension glaucoma typically receive the same methods of treatment used for open-angle glaucoma.
Some people who have elevated eye pressure but do not yet have glaucoma may also benefit from treatment with eyedrops. These patients are described as having ocular hypertension.
Glaucoma maybe detected by eye examination and tests such as visual fields, HRT and OCT scan.
Laser scans of the optic nervr such as the HRT and OCT disc scans at the Windsor Eye Clinic provide accurate measurements to enable better monitoring and detection of any change so that treatment plans can be optimised.
Once glaucoma is diagnosed, treating it is a team effort between you and your doctor. How your glaucoma is treated will depend on your specific type of glaucoma, the severity of your disease and how it responds to treatment.
The most common way to treat glaucoma is with medicated eye drops
The eye drops must be taken on a daily basis. Just like any other medication, it is important to take your eye drops regularly as prescribed by your ophthalmologist.
Never change or stop taking your medications without consulting your doctor. If you are about to run out of your medication, ask your doctor if you should have it refilled.
In Some patients with glaucoma, medication does not work effectively so surgery is recommended. Glaucoma surgery improves the flow of fluid existing the eye, resulting in the lower eye pressure.
To treat open-angle glaucoma, a procedure called laser trabeculoplasty is sometimes used. During surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork.
Even if laser trabeculoplasty is successful, most patients continue taking medications after surgery. The laser trabeculoplasty successfully lowers eye pressure three quarters of the time, but for many people the surgery is not a permanent solution. Nearly half who receive this surgery develop increased eye pressure again within five years. Many people who have had a successful laser trabeculoplasty have a repeat treatment.
To treat closed-angle glaucoma and patients with dangerously narrow drainage angles, a procedure called laser iridotomy is recommended. In laser iridotomy, a laser creates a small hole in the iris to improve the flow of aqueous fluid to the drainage angle.
When laser iridectomy is unable to stop an acute closed-angle glaucoma attack, or is not possible for other reasons, a peripheral iridectomy is performed. The peripheral iridectomy is performed in an operating room. A small piece of the iris is removed, giving the aqueous fluid access to the drainage angle again. Because most cases of closed-angle glaucoma can be treated with medications and laser iridotomy, peripheral iridectomy is rarely necessary.
Trabeculectomy is a procedure that creates a new drainage channel for the aqueous humor to leave the eye.
Aqueous Shunt Surgery
When the risk is high that trabecuplasty will fail, aqueous shunt surgery may be recommended. An An aqueous shunt is a small plastic tube or valve connected on one end to a reservoir (a roundish or oval plate). The shunt serves as an artificial drainage device and is implanted in the eye through a tiny incision.
Vision loss from glaucoma usually can be prevented if it is detected and treated early enough.
If you use eyedrops to treat your glaucoma, be sure to continue taking the medication as your doctor tells you to. Never change or stop taking your medications without consulting your doctor.
There are a number of ways to treat glaucoma. While some people may experience side effects from medications or surgery, the risks of side effects should always be balanced with the greater risk of leaving glaucoma untreated and losing vision.
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Windsor Eye Clinic
160 Bridge Road
T: 01753 852299
F: 01753 842200