Eye Conditions

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Glaucoma


Glaucoma is a common eye condition, affecting 1% of the general population and 2% of those over the age of 40 years in the United Kingdom. Glaucoma usually arises when the pressure in the eyes is too high, causing damage to the optic nerves. People who have relatives affected by glaucoma are at a slightly higher risk of developing glaucoma in their lifetime, and for these people, testing for glaucoma therefore regularly is advisable.

DIAGNOSIS AND MONITORING

Unfortunately, many people who develop glaucoma have virtually no symptoms. If the condition is not diagnosed in its early stages significant visual loss can occur. Regular testing for glaucoma is therefore essential to prevent this.
In order to determine if there are any signs of glaucoma, important tests are required such as a visual field test to check peripheral (outer) vision, and imaging of the optic discs (OCT- Optical Coherence Tomography) to detect the very earliest signs of high pressure-related optic nerve damage.
For all people with either glaucoma or increased eye pressure (ocular hypertension), regular, long-term check-ups are essential. Usually, once the diagnosis is made and treatment has been shown to control the eye pressures, check-ups are every 6 to 12 months are recommended, depending on the severity of the glaucoma.

TREATMENT

For many patients with glaucoma all that is needed to prevent glaucoma progression are daily eye-drops and regular monitoring by a glaucoma specialist. Eye-drops are the mainstay of treatment for glaucoma and are highly effective for the vast majority of glaucoma patients.

Laser and Surgery for Glaucoma

For a very small number of people with glaucoma, eye-drops are not enough to maintain normal eye pressures and prevent damage to their vision. If progressive optic nerve damage and peripheral loss of vision are detected, despite using eye-drops, either Laser treatment or surgery to lower the eye pressure may be recommended.

Some types of glaucoma are especially responsive to certain types of Laser treatment. Examples include Laser trabeculoplasty for open angle glaucoma, and YAG Laser iridotomy and Argon Laser iridoplasty for narrow angle glaucoma.

In a minority of cases where eye-drops do not adequately control the eye pressures, surgery may be the only way to control glaucoma and safeguard eyesight. A procedure called trabeculectomy is the gold standard surgical treatment and has the best chance of successfully lowering the eye pressure to safe levels.

Very occasionally, trabeculectomy is ineffective in controlling complex glaucoma, and other more advanced surgical procedures may be recommended, such as glaucoma drainage implant surgery.

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Specialist

Richard Packard

Richard Packard has been director of Arnott Eye Associates, the internationally recognised centre for ophthalmic excellence, since the retirement of Eric Arnott in 1999... Read More