A name given to a group of eye conditions caused by a damaged optic nerve, glaucoma is one of the world’s leading causes of blindness. Although vision lost to glaucoma cannot be regained, early detection and diagnosis of the condition will prevent further vision loss from taking place. Coupled with careful monitoring and regular treatment, patients suffering with glaucoma can retain useful sight for life.
Why it occurs
More often than not, the damage to the optic nerve occurs due to the pressure within the eye pushing down on the nerve and damaging it. The optic nerve is a crucial player in an individual’s sight, it is tasked with carrying sight images to the brain. While a certain amount of pressure is necessary for the eye to keep its shape, excessive pressure will destroy fibres in the eye—leading to vision loss. Unlike other eye conditions, glaucoma doesn’t usually cause any obvious symptoms, therefore regular eye checks are vital. If it is left untreated, total loss of vision can occur in extreme cases.
Although it is still relatively unclear why glaucoma occurs, there are certain risk factors that can increase an individual’s risk of developing the condition. These include: age, glaucoma is more common in old age; ethnicity, people of African, Caribbean or Asian origin are at a higher risk; family history; and other health conditions such as diabetes and long and short-sightedness.
Treatment
Although treatment for glaucoma can’t reverse loss of vision, it can stop it from getting worse. Available treatments for the condition include surgery, specialist eye drops and laser treatment. It’s also important to remember that treatment will depend on the severity and type of the condition.
Eye drops work to reduce the pressure in the eyes and are normally used from one to four times a day. Although this is the most common treatment for glaucoma, eye drops can cause unpleasant side effects such as eye irritation.
Laser treatment is usually a course of action that is recommended if eye drops are deemed to not be working. This type of treatment consists in high-energy beams of light being aimed at the eye to stop fluid from building up inside it. The three main types are: laser trabeculoplasty, where a laser opens up the drainage tubes within the eyes to reduce pressure; cyclodiode laser treatment, which uses a laser to destroy the eye tissue that produces the liquid; and laser iridotomy, a procedure which creates holes in the iris to flush out fluid from the eye. This type of treatment is usually performed while the patient is awake and under local anaesthetic in the form of numbing eye drops.
In rare cases, surgery may be recommended if treatment with laser or eye drops hasn’t been effective. Trabeculectomy, the most common type of surgery for glaucoma, involves allowing the fluid buildup to drain more easily by removing part of the eye drainage tubes. This type of surgery can be carried out both under local anaesthetic or general anaesthetic. According to the NHS, patients who choose this route rarely present with pain after surgery and find they no longer need to take eye drops to manage the condition. Your doctor should discuss the different types of glaucoma surgery, whilst outlining the risks and side effects. Other types of glaucoma surgery include: trabeculotomy, where an electric current is used to remove a part of the eye drainage tubes; viscocanalostomy, the removal of the sclera (the white outer covering of the eyeball) to facilitate fluid drainage; deep sclerotomy, where the drainage tubes in the eye are widened; and trabecular stent bypass, where a tiny tube is placed into the eye to increase fluid drainage. Post-surgery, the affected eye may water and your vision may be slightly blurred for up to six weeks—this should all return to normal thereafter.
Symptoms
Glaucoma doesn’t present with symptoms to begin with—it tends to develop slowly over time and affect peripheral vision first. However, occasionally, the condition develops quickly, causing symptoms such as:
- Intense eye pain
- Nausea and vomiting
- A red eye
- A headache
- Tenderness around the eyes
- Seeing rings around lights
- Blurred vision
Remember
It’s vital to attend regular follow-up appointments to monitor your vision and check that treatment is working
