What is Glaucoma?
Glaucoma is the term given to a group of eye conditions which affect the optic nerve inside your eye. The optic nerve connects your eye to your brain so that you can see. In most types of glaucoma, increased pressure of the fluid inside your eye causes damage to your optic nerve, which may affect how well you see. The most common form of glaucoma is chronic glaucoma, and the most common form of chronic glaucoma is primary open angle glaucoma (POAG). Although anyone can develop chronic glaucoma, some people are more at risk than others. The early stages of chronic glaucoma do not cause symptoms, but your optometrist can do certain tests to detect early signs. Your optometrist will be able to tell you if you have a higher than usual risk of glaucoma and how often you should have regular eye examinations. If they suspect you have glaucoma, they will refer you to a specialist for diagnosis. There is no cure for chronic glaucoma, but it can be treated very effectively with eye drops to reduce the pressure inside your eye and help prevent your sight from being affected.
How is Chronic Glaucoma Detected?
The early stages of chronic glaucoma do not cause symptoms. This means it is important to have regular eye examinations so glaucoma can be detected before it affects your sight. There are three main tests to see if you may have chronic glaucoma. The first one is where your optometrist looks at the nerve at the back of your eye. They may use OCT to scan the nerve, this can be useful for future visits, to help them see if things have changed. The second test is where the optometrist measures the eye pressure. We prefer to use the iCare tonometer as most patients find this technique very gentle as well as providing accurate results. The third test is a check on your visual field where the optometrist tests how far you can see around you when you are looking straight ahead. This is done using an instrument called a visual field screener.
Sometimes you can have chronic glaucoma even if you have normal eye pressure. This is why you will usually have at least two of these three tests. If the results are not clear, you may be asked to do one or more of the tests again on a different day. The optometrist may also carry out additional tests.
Treating Chronic Glaucoma?
If your optometrist suspects that you have chronic glaucoma, they will refer you to an ophthalmologist (a specialist eye doctor) for a diagnosis. This may involve you having more tests. There is no cure for chronic glaucoma but it can be treated effectively, normally with eye drops which you use every day. These reduce the pressure in your eye. You will not feel that anything is happening, but you must ensure that you keep using the drops, as your sight could be much worse if you stop the treatment. It is also important that you attend your follow up appointments.
Acute Glaucoma – Angle Closure Glaucoma
This is a type of glaucoma where the drainage channels inside your eye are blocked or damaged in some way. This causes the pressure inside the eye to increase and lead to a type of glaucoma called primary angle closure glaucoma. Sometimes the pressure rises quickly, and this is called acute angle closure. Sometimes the increased pressure can come and go, which may cause short bursts of pain, discomfort or blurred vision. This can happen when your pupils get bigger, so you may notice it at night or when you are in a dark area (for example, at the cinema). You might also have an ache in your eye (which may come and go), nausea and vomiting, or red eyes. You may see coloured rings around white lights, or it can be a bit like looking through a haze or mist.
If you get these symptoms it is important to act quickly, even if the symptoms appear to go away. This is because your vision may be damaged each time you notice the symptoms. You should contact your optometrist for advice immediately. If they are not available, you should go to your nearest eye casualty unit or A&E as soon as possible. These symptoms may be related to the narrow drainage channels. You may need immediate treatment. If you need treatment, the eye specialist can reduce the pressure and get rid of the pain. If you have had these symptoms but they have gone away, you should see your optometrist as soon as possible and tell them about your symptoms. Risk factors for acute angle closure glaucoma include:
- From an East Asian or South Asian background
- Family history of angle closure glaucoma
- Long-sighted
- Over 40
- Female
Treating Acute Glaucoma
Acute glaucoma requires prompt treatment. The first step is to lower the eye pressure. This is done using eye drops and an intravenous injection. Once the pressure is lowered, your ophthalmologist may use a laser or surgery to bypass the blockage in your eye’s drainage system to prevent the problem coming back.
Need Help?
If you are concerned about any aspect of your eye health including glaucoma get in touch with our team of experienced Optometrists for further information and help.