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Eye Health Information

Glaucoma

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Glaucoma

Introduction

Glaucoma is a disease of the optic nerve which is usually associated with high pressure inside the eye.  Glaucoma has been labelled the “sneak thief of sight” because many people remain undiagnosed until irreversible vision loss occurs.

In Australia 300,000 people have glaucoma, with projections forecasting this figure to rise to 400,000 by 2025 due to our ageing population.

Causes

The front part of the eye is filled with a clear fluid called ‘aqueous humor’.This fluid is continuously produced and constantly flows out of the eye, maintaining a steady pressure. If the fluid fails to flow out of the eye properly, the pressure will increase causing glaucoma.

Types of Glaucoma

Primary or chronic open angle glaucoma is the most common kind, with two thirds of cases presenting with this type. It occurs when the ‘drainage angle’ (the area where the fluid leaves the eye) appears to be open, but does not function properly and pressure within the eye increases.

Occasionally the drainage angle of the eye may become narrow and close gradually, this is called chronic angle closure. If the drainage angle closes suddenly it is called acute angle closure.

Acute angle closure glaucoma causes severe sudden pressure rise and is typically painful with the development of redness.  Vision may become blurred, and halos may be seen around bright lights. Other symptoms can include headaches, nausea and vomiting. Chronic angle closure leads to gradual pressure, however, does not respond well to standard medicine such as eye drops.

Symptoms

Raised eye pressure cannot be felt unless it quickly becomes noticeably elevated, as in acute angle closure glaucoma, most patients are therefore unaware they have glaucoma. The symptoms for acute angle glaucoma are mentioned above.

Diagnosis

Regular eye examinations are the best way to detect glaucoma. An examination will measure the fluid pressure, examine the drainage angle, test the visual fields, and examine the optic nerve.  The test will take 20-45 mins and is conducted by an ophthalmologist.

Risk Factors

Research suggests that some factors may increase the risk of glaucoma developing, including;

  • age,
  • family history,
  • past injuries to the eye,
  • other eye diseases,
  • high eye pressure,
  • near-sighted or myopic patients.

Treatment

Eye drops, oral medication, and or surgery are used to treat the different types of Glaucoma. An ophthalmologist can decide which treatment option is best suited to you.

Surgery

The most common operation is a Trabeculectomy, this procedure creates a new drainage channel for fluid to leave the eye, and is performed in an operating theatre using a microscope. Local anaesthetic is usually used, but occasionally a general may be preferred. Patients leave the hospital on the day of surgery and are followed up closely. The surgery is 90% effective, however, like all surgery there are risks involved.

Laser surgery

Laser surgery is effective in different types of glaucoma. This is a painless procedure performed as an outpatient and comes with minimal side effects. Local anaesthetic eye drops are given and a special instrument is placed on the surface of the eye to hold the eyelids open.

The Lions Eye Institute also conducts an array of Clinical Trials. You can view these on our Clinical Trials page.

Further Information & Support

For further information on Trabeculectomy Surgery, laser surgery and medications, including the associated risks, implications and recovery, view our downloadable PDF.

If you have any questions or concerns regarding any aspect of glaucoma treatment, please discuss these with an ophthalmologist.

What’s Next?

Please contact The Lions Eye Institute to make an appointment with the appropriate ophthalmologist.  A current referral from either a GP, or an optometrist, is required for all appointments.

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