World Glaucoma Awareness Week runs this month from March 10-16 so at Envision Optical this month we are concentrating our eye health awareness message on the very common eye sight threatening disease: glaucoma.  Glaucoma is the leading cause of avoidable blindness in Australia, affecting over 300 000 people, and it its estimated that 50% of sufferers are yet to be diagnosed.

As an independent Gold Coast and Tweeds Heads optometrist focused on eye health care we want to dispel the myth that glaucoma only affects the elderly, We want to encourage anyone at risk of developing glaucoma to get their eyes tested, especially if you have a family history of glaucoma as you are 10 times more likely to develop glaucoma if you have a direct relative with it.

What is glaucoma?

Glaucoma is a disease where the optic nerve at the back of the eye, which connects the eye to the brain, is progressively decaying. It is most commonly associated with raised fluid pressure inside the eye. The progressive decay of the optic nerve causes a gradual loss of peripheral vision, and if left untreated, the patient will eventually have severe irreversible vision loss and blindness, and a form of tunnel vision.

What Causes glaucoma?

There are a number of different forms of glaucoma with individual unique causative factors. Many are related to structural changes within the eye that impede the outflow of the internal fluid leading to increased eye pressure. Glaucoma genes have been identified in recent studies, and there has been shown to be a 10 times greater risk if you have a direct relative with the condition. Patients with diabetes, , myopia, cardiovascular disease, prolonged steroid use, migraines and previous eye injury or surgery are also more likely to be affected.

What are the symptoms of glaucoma?

There are usually NO SYMPTOMS in most forms of glaucoma, so it is vitally important for everyone to have their vision and eye health check every two years at least. It is only in cases of extreme high eye pressure that you would experience any pain or discomfort. More than 300 000 Australians have glaucoma, with up to half unaware they have the disease. In advanced cases of glaucoma, patients can experience tunnel vision.

How do we detect glaucoma?

At Envision Optical our optometrists always perform a thorough examination of the optic nerve health and check your intraocular pressure at every full examination. We recommend Digital Retinal Photography as the best method of recording the optic nerve health to allow for ease of future comparison. It is a change in the nerve structure that makes us suspicious of glaucoma so documenting current health status makes future comparison much more meaningful. If glaucoma is suspected, we will recommend undergoing computerised peripheral visual field assessment, OCT nerve scan, OCT corneal thickness assessment, and gonioscopy. All of these tests give extra information regarding the likelihood of glaucoma and the result will be analysed before deciding if referral to an ophthalmologist is required for possible treatment.

How is glaucoma treated?

If the results of testing indicate a high likelihood of glaucoma you will be referred to an ophthalmologist for confirmation of the diagnosis and commencement of treatment. Treatment is crucial because you will experience loss of vision and gradually go blind if nothing is done. Most patients are able to be successfully treated by using eye drops which lower the pressure inside your eyes. This has been shown to be an effective treatment to prevent progressive nerve damage and subsequent vision loss. There is no permanent cure. The treatment is ongoing and will require daily instillation of drops, usually for the rest of your life. Initially follow up testing of peripheral vision and optic nerve scans will likely be done at least every six months to monitor for further deterioration to ensure the drops are working.  Envision optical optometrists are able to work co-operatively with your eye specialists to assist in management and even write repeat prescriptions for your eye drops.

Surgical treatment of glaucoma

If drops are ineffective, further treatments by laser or surgery will be considered by your specialist to effectively lower your eye pressure.  Laser trabeculoplasty treatment consists of targeting the area of the eye that drains out the fluid to more effectively lower the eye pressure. Several treatment sessions are often required. Surgical treatment involves creating a more effective fluid outlet surgically to ensure adequate pressure control. In extreme cases, drainage valves can be inserted into the eye although this is rare. In the vast majority of cases, eye drops will give effective pressure control.

What should I do to guard against developing glaucoma?

  • Visit Envision Optical for regular eye health checks at least every two years
  • Follow Envision Optical optometrists recommendation and have the health of your optic nerve recorded by retinal photography to aid in future comparison
  • If anyone in your family develops glaucoma, make sure everyone knows that family members are at a greater risk of developing glaucoma and risking subsequent vision loss
  • Make sure that you have adequate vitamin C intake along with magnesium, Fish oil and even Gingko Biloba. No matter what: its good for you!

Next post I’ll share with you an excellent overview of lifestyle and diet considerations in glaucoma.

Post by: Andrew Bowden, Optometrist