For most glaucoma patients the condition cannot be cured, however early detection and treatment can prevent this disease from causing permanent blindness.
Glaucoma is a common condition; it’s estimated that more than 90,000 New Zealanders over the age of 40 have the disease. It is one of the main preventable causes of blindness in New Zealand. Glaucoma can run in families, although most patients will not have a relative with the condition.
There are several types of glaucoma:
Open-angle glaucoma
This is the most common form of glaucoma, accounting for up to 70 percent of cases. It occurs when the eye’s internal drainage system becomes blocked and doesn’t drain properly – leading to raised eye pressure and subsequent damage to the optic nerve.
Open-angle glaucoma develops slowly, often with no symptoms, and vision loss is gradual.
Normal-tension glaucoma
This form of glaucoma is similar to open-angle glaucoma but with a pressure in the eye that is not above the usual normal range; it is just too high for that individual. Also called low-tension or normal pressure glaucoma, the treatment and management is similar to open-angle glaucoma.
Acute closed-angle glaucoma
This type of glaucoma can develop rapidly and is considered an emergency. A sudden increase in eye pressure is the result of a blockage to the eye’s drainage area (also known as the angle). This causes blurred vision, eye pain and redness. Other common symptoms include nausea and vomiting; if you think you may be suffering from this condition please seek urgent medical attention.
Pigment dispersion
Pigment particles released from the iris can block the eye’s drainage canals, resulting in raised pressure in the eye. As with other forms of glaucoma, this increase in pressure causes damage to the optic nerve. Patients with this condition sometimes experience eye pain after physical activity.
Pseudoexfoliation syndrome
Caused by a build-up of protein fibres in the eye, which prevents fluid from draining and increases the pressure in the eye. If left untreated, this can go on to cause pseudoexfoliative glaucoma.
Ocular hypertension
This describes a condition where pressure in the eye is high, but this hasn’t yet gone on to cause the damage associated with glaucoma. Sometimes this needs treating to reduce the risk of glaucoma developing, but can sometimes be safely observed.
When you are first assessed at St George’s Eye Care your ophthalmologist will confirm whether you have glaucoma and which type of glaucoma you have.
Glaucoma symptoms
Initially the majority of patients with glaucoma will not have symptoms or be aware of the condition. Because of this, early detection of glaucoma is important to prevent permanent vision loss. People over the age of 45 are advised to visit their optometrist every five years for a glaucoma eye check. If you are considered high risk for glaucoma (see section below) your optometrist may suggest an annual eye check.
When the condition is advanced patients might notice the following:
- loss of peripheral vision
- blurred vision
- difficulty adjusting to low light
People with closed-angle glaucoma may experience headaches, eye pain and blurred vision from time to time. If this becomes persistent with nausea, vomiting and eye redness, it may be acute closed-angle glaucoma and you should seek urgent medical attention.
Who is at risk of glaucoma?
Risk factors for glaucoma include:
- a family history of glaucoma
- being older than 40 years
- significant short or long-sightedness
- long-term steroid medication
- history of migraines
- diabetes
- previous eye injury
The only way to diagnose glaucoma is with a comprehensive eye examination. If glaucoma is suspected you will be referred to an ophthalmologist for further tests to confirm the diagnosis and discuss treatment options.
Treatment for glaucoma
For most forms of glaucoma, there is no cure. Treatment involves preventing the condition from getting worse, followed by life-long monitoring.
At St George’s Eye Care we offer the following treatment options:
Medication
Medicated eye drops are commonly used for glaucoma, as they very effectively lower the pressure within the eye and prevent further damage to the optic nerve. These eye drops are used daily.
Glaucoma laser treatment
Laser treatment can be performed instead of, or as well as, eye drops. Selective Laser Trabeculoplasty (SLT) is often used to manage open-angle glaucoma. The laser helps to increase the porous nature of the drainage area for the eye, allowing fluid to drain from the eye and reduce pressure. Peripheral Iridotomy Laser is used for some cases of closed-angle glaucoma. This straightforward procedure is very safe and can be performed in our consulting rooms.
Minimally Invasive Glaucoma Surgery (MIGS)
If your glaucoma is more advanced, or doesn’t respond to laser therapy or eye drops, you may need to consider surgery. This involves inserting a very small tube in the eye to help fluid drain and reduce pressure.
At St George’s Eye Care we offer Minimally Invasive Glaucoma Surgery (MIGS), which involves smaller incisions, faster recovery and less complications. MIGS is performed under local anaesthetic in our state-of-the-art operating theatres at St George’s Hospital.
Cataract surgery
Although cataract surgery is usually performed for vision improvement, it will often have a beneficial effect on the pressure in the eye. For certain forms of glaucoma this pressure-lowering effect can be dramatic. Cataract surgery can also be combined with MIGS (see above) to further reduce the intraocular pressure.
Your ophthalmologist can advise which treatment option is best for you, based on your needs.
Why choose St George's Eye Care for your glaucoma treatment?
Our two ophthalmologists, Dr Paul Baddeley and Dr Oliver Comyn, are highly skilled and have many years of experience. They both worked at prestigious eye hospitals in the United Kingdom and are regularly involved in clinical research.
They have advanced training in glaucoma surgery and use the latest surgical techniques, including Minimally Invasive Glaucoma Surgery (MIGS), which reduces recovery time and complications.
Depending on which surgical option you require, glaucoma surgery is performed in our consulting rooms or state-of-the-art operating theatres at St George’s Hospital.
We encourage you to play an active role in your treatment plan, and we take a personalised approach. You will see the same ophthalmologist before, during and after your treatment, and we work directly with your GP or optometrist as part of your long-term eye care team.
Raising awareness
Glaucoma can run in families and is very common – it’s estimated that more than 90,000 New Zealanders over the age of 40 have the disease.
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We look forward to talking with you soon.
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