WHAT IS GLAUCOMA?
Glaucoma is a painless eye disease which can reduce your field of vision. Glaucoma is one of the leading causes of blindness in the UK, so it is important to detect it early. Glaucoma is not truly curable, but it is easily managed through eye drops, laser treatment, surgery, or a combination of all of these.
One of the most common signs of glaucoma is a raised pressure inside the eye (Intra-Ocular Pressure). Therefore, your Optometrist does the ‘puff of air test’ when you get your eyes assessed. Unfortunately, this test is not as accurate as the gold-standard ‘blue light’ test used in our clinics and the hospital; we combine this with a series of other measurements and scans to create an accurate picture of your glaucoma status and risk.
There are several different types of glaucoma, most of which can be treated by our clinicians:.
OCULAR HYPERTENSION (OHT)
This means that the pressure in your eye is higher than ‘normal,’ but you do not have glaucoma because your increased eye pressure has not caused any damage.
Ocular hypertension does increase your risk of glaucoma, but many people have ocular hypertension and simply require monitoring without any treatment.
Some people with ocular hypertension do require treatment to lower their eye pressure and reduce their risk of developing glaucoma in the future.
OPEN-ANGLE GLAUCOMA (OAG)
Open-angle glaucoma is the most common type of glaucoma we see and look after in our clinics. Quite often patients have no idea they even have it, as most have no symptoms at all. Often, the first time you know about it is the puff-of-air test at your routine eye test.
In most cases, open-angle glaucoma is manageable through either medication or laser treatment to reduce the IOP, but it does require regular long-term monitoring.
ANGLE-CLOSURE GLAUCOMA (ACG)
Angle-closure glaucoma is where the drainage channels inside the eye become narrowed. This causes the fluid to build up and increases the pressure inside the eye (IOP).
This can be treated with drops but sometimes laser treatment or surgery are required, in both cases there is an extremely high success rate. After surgery, you will continue to be monitored regularly to ensure the IOP does not start to rise again.
NORMAL-TENSION GLAUCOMA (NAG)
Normal-tension glaucoma is remarkably similar to open-angle glaucoma, except the eye pressure (IOP) is not high and stays within normal ranges.
This can be more difficult to manage, and you might be referred into the NHS Trust hospital for further management.
It is extremely important to follow the advice you receive on treating your glaucoma due to the risk of irreversible sight loss.
Each type of glaucoma will need a slightly different approach to management. Treatment is mostly through prescription eye drops, laser treatment or both combinations.
Selective Laser Trabeculoplasty (SLT)
SLT laser treatment is recommended by NICE as the best practice treatment for open-angle glaucoma. SLT is available in Evolutio clinics, and your clinician will discuss if you are suitable for this.
SLT laser treatment is painless, takes less than an hour, and means your glaucoma can be managed with fewer eye drops. This is preferrable as the long-term use of glaucoma eye drops can cause irritation and redness, and eye drops MUST be taken every day.
SLT laser treatment lasts between 3 and 5 years in most patients and can be repeated if necessary.
Glaucoma has traditionally been managed through daily prescribed eye drops. In some cases, this may be a combination of several different drops, and they must be taken at the correct time every day to be effective.
These drops would be arranged on repeat prescription from your GP and need to be collected regularly.
Peripheral Iridotomy (PI) Laser Surgery
In some cases of closed-angle glaucoma, the fluid drainage can be improved by making a tiny hole in the coloured part of the eye (iris) with a laser. This reduces the IOP and rarely needs to be repeated. PI laser can be done in an Evolutio clinic in less than an hour; it is a highly effective treatment but only suitable for specific cases.
In almost all cases, once diagnosed with glaucoma you will need to be regularly checked to ensure the treatment is still working and that the glaucoma is not progressing.
Age is the predominant risk factor for developing glaucoma.
However, your risk of glaucoma increases where you have family members with glaucoma or if you’re of black African or black Caribbean ethnic origin.
Occasionally other eye diseases can lead to glaucoma.
There is at least a four times increased risk of developing glaucoma if you have a close blood relative with the condition (father, mother, brother, sister, or child).
As such, if you are diagnosed with glaucoma it is important you reach out to family members so they are aware and can get tested.