Glaucoma

Disease of the optic nerve

• Causes loss of peripheral vision initially
• Can lead to tunnel vision and can progress to blindness.

In most types of glaucoma, the nerve damage occurs slowly over a period of years and creates blind spots in peripheral vision.

Glaucoma is often associated with high pressure in the eye (diagram below) but can also be associated with normal eye pressure:

As the disease progresses, these blind spots enlarge and grow together. It is common for a person not to notice they are afflicted until the later stages of the disease, when the central vision becomes affected. At this point, severe and irreversible vision loss has occurred.

In a less common form of glaucoma, called acute angle-closure glaucoma, patients may experience sudden onset of a red, painful eye with blurred, steamy vision and see haloes or rainbows around lights. This is a Medical Emergency and requires immediate and urgent treatment to lower the eye pressure and prevent blindness.

Risk Factors

• Age (more common after age 50)
• High Hyperopia (for acute glaucoma)
• Diabetes
• Myopia
• Family history
• Trauma to the eye
• Infections and inflammation
• Some medications
• Increased pressure in the eye

Treatment and Management

Most cases of glaucoma, if detected early, can be successfully controlled, provided the patient is compliant with using their medication and returning for regular monitoring and follow-up care.

• Daily eye drops
• Oral medications (for acute glaucoma)
• Laser surgery
• Ocular microsurgery

Glaucoma patients require lifelong monitoring.

Prevention and Detection

• Visit your optometrist on an annual basis for a complete eye health assessment.
• Early detection and treatment can improve long-term outcomes.
• Automated testing including regular Visual Fields and HRT laser scanning are critical in detecting early glaucoma and in monitoring change over time to prevent progression.