Glaucoma

What is glaucoma?

Glaucoma is a group of eye conditions resulting in optic (eye) nerve damage, which may lead to irreversible blindness if left untreated. Long term inappropriately high eye pressures (i.e. intraocular pressures) can cause damage to the optic nerve. The most common types of glaucoma – Primary Open Angle Glaucoma and Angle Closure Glaucoma, have completely different symptoms.

The symptoms of primary open angle glaucoma include:

• Gradual loss of peripheral vision
• Tunnel vision in the advanced stages

NO GLAUCOMA

EARLY GLAUCOMA

MODERATE GLAUCOMA

LATE GLAUCOMA WITH TUNNEL VISION

The symptoms of acute angle closure glaucoma include:

• Severe eye pain
• Eye redness
• Nausea and vomiting
• Headaches
• Haloes around lights
• Decreased vision

ACUTE ANGLE CLOSURE GLAUCOMA

Secondary glaucoma can arise from conditions such as long term steroid use, diabetes, mature cataracts, and prior eye trauma.

Paediatric glaucoma is a rare form of glaucoma which can occur at birth or later in childhood. Signs and symptoms include enlargement of the eyes, a "glassy" appearance of the eyes, tearing, eyelid spasm and a rapid increase in myopia.

When should you see an eye doctor?

Don't wait for noticeable eye symptoms. Unfortunately, primary open angle glaucoma will not have many symptoms until the late stage when vision is impaired. Regular eye exams, especially if you have a family history of glaucoma is key to early detection.

Angle closure glaucoma often presents acutely, where eye pain, redness, tearing, vomiting and headaches are prominent symptoms.

Our specialized glaucoma evaluation tests include:

1. Automated perimetry

• Humphrey visual field testing to define the extent of visual impairment

2. Optic nerve photography

• To document baseline and progression of optic nerve damage

3. Tonometry

• Eye pressure measurements

4. Pachymetry

• To measure cornea thickness for correlation with eye pressure measurements

What are the available modalities of treatment?

Treatment needs to be individualized, as each patient's target intraocular pressure is dependent on the extent of damage to the optic nerve and visual field. Unfortunately, pre-existing visual function damage cannot be reversed but the aim is to preserve and maintain visual function.

There are many modalities for treatment of glaucoma and may differ according to the subtype of glaucoma. These include:

Medications – eye pressure lowering eye drops

Laser therapy

• Argon laser trabeculoplasty
• Selective laser trabeculoplasty
• Laser peripheral iridotomy
• Transscleral cyclophotocoagulation

Surgical therapy

• Trabeculectomy with anti-metabolites
• Glaucoma drainage implants eg: Ahmed tube
• Cataract removal with trabeculectomy