Vision Scotland : Glaucoma

Glaucoma

If you suddenly develop blurred vision or start seeing rainbows around bright lights, you could be suffering from glaucoma – caused by damage to the optic nerve.

Close up of a human eye

What is glaucoma?

There are lots of different types of glaucoma but the most common type is called Chronic Simple Glaucoma. 

 Across the UK the prevalence of the condition is around two per cent for people over the age of 40 years. This prevalence rate increases to around six per cent in people over the age of 65 years. And people of African origin are more likely to be affected.

Experts also say if you have a brother or a sister affected you are much more likely to develop the condition.

Congenital glaucoma

Congenital glaucoma, also known as childhood glaucoma, is rare but affects children and young people. It is categorised as either primary or secondary. Primary glaucoma does not develop from an illness or condition. Secondary congenital glaucoma can develop from an injury or disorder.
what are floates
Cat, Optometrist at Vision Scotland

Diagnosis

One of the major problems with chronic glaucoma is diagnosis. There are few symptoms until the condition is advanced.
It begins as an increase in pressure inside the eyes and this persists over a period of time. This then progresses to cause damage at the back of the eye and when the nerves at the back of the eye are damaged it then goes on to cause peripheral vision problems.

The brain compensates for any initial peripheral vision loss so potential blank patches in vision won’t be noticed. Gradually these blank passages will enlarge and affect your central vision.

In order to identify glaucoma, the eye pressure can be measured which is a good indicator whether something is wrong. Also, the optic nerve can be investigated using specialist equipment.
A visual test field can also be performed. There needs to be a 30 per cent performance loss before a visual field test can pick up any abnormality which is why your specialist can also use other specific instrumentation.

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Treatments

The main treatment for glaucoma is eye drop therapy. Importantly patients need to continue to use drops as long as their GP says it is necessary. It can be a case of using drops ‘long term, over the course of the rest of their life to prevent any sight loss.
Alternatively patients can have laser surgery which is painless and can be done as a day case procedure. It takes a matter of minutes.

Another possibility is MIGS or minimally invasive glaucoma surgery. This is a surgical option to reduce eye pressure. This type of surgery is often combined with cataract surgery. There are a number of types available.
If, following eye drop treatment and laser surgery it’s deemed that the glaucoma is progressing then it is possible to have another operation. The aim of this operation is to release fluid from inside the eye to the outside by creating an artificial passage through the white of the eye.
However, over a period of time the surgery can become less efficient. It is very rare to lose sight from glaucoma provided patients present at an early stage. You can get a test at your local opticians.

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Mr Ross discusses cataract surgery
surgery for glaucoma

Acute Angle Closure Glaucoma (AACG)

This is where the aqueous humour (an internal eye fluid) drains through the trabecular meshwork. If this angle becomes too narrow, it can block this drainage and cause the pressure in the eye to rapidly and dramatically increase. This typically causes pain, a red eye, hazy vision and possible halos around lights. If untreated or treatment is delayed AACG can cause serious loss of vision. The treatment of an event of Angle Closure is an Ocular Emergency.
People who are prone to AACG include those with advanced cataracts, patients with moderate to high long sightedness and people with a family history of AACG.

There are surgical procedures available to reduce your risk of developing AACG.

These include:

  • Early cataract surgery
  • Lens replacement surgery
  • YAG laser peripheral iridotomy.


We offer all of these treatments at Vision Scotland. Make an appointment to discuss the best procedure for you.

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