GLAUCOMA

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Medical Management

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Laser Therapy

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Surgery

Glaucoma

Glaucoma is a condition often associated with elevated pressure within the eye. This gradually damages the delicate nerve of the eye. This can cause permanent visual loss if left untreated. Unfortunately, by the time someone notices that they are having problems from glaucoma, they may already have lost a considerable amount of vision that cannot be recovered. Glaucoma can take many years to develop, so tests to diagnose glaucoma may need to be repeated.

What is Glaucoma?

Glaucoma is a condition often associated with elevated pressure within the eye. This gradually damages the delicate nerve of the eye. This can cause permanent visual loss if left untreated. Unfortunately, by the time someone notices that they are having problems from glaucoma; they may already have lost a considerable amount of vision that cannot be recovered. Glaucoma can take many years to develop, so tests to diagnose glaucoma may need to be repeated

What can be done?

Screening tests can pick up people who are at risk of early glaucoma and these tests are all available at Stanley Eye Unit. If glaucoma is detected and treated early enough, visual loss is preventable. The secret to effective glaucoma management is early diagnosis, effective treatment and identifying those at highest risk of glaucoma damage.

Below is some further information about glaucoma tests and treatment. If you would like to talk with us about our treatments or have any questions, please contact us.

Tests to Diagnose Glaucoma

At our unit, state of the art glaucoma testing will be used. No single test can diagnose glaucoma
and several investigations are recommended You will then see the consultant who will personally
advise bout treatment and future follow up.

Measurement of the intraocular pressure
Firstly anaesthetic eyedrops are instilled. A delicate instrument (known as a tonometer) is gently placed on the surface of the eye and a pressure reading is taken. The procedure takes less than a minute and is completely painless. This method is more accurate than the puff of air that is often used by opticians and most patients find it more comfortable.
Field of Vision
There are many instruments which can be used to measure visual fields (peripheral vision); the Humphrey Computerised Visual Field Analyser is generally regarded to be the best. Tiny spots of light appear at various times and the patient presses a button to record when they see the lights. A chart showing any areas of visual loss is developed and printed. The test takes about 4 minutes to perform for each eye and once again, it is completely painless.
Retinal Imaging
Scanning devices such as ocular coherence topography (OCT) and digital photography are used to record the back of the eye. These images provide a useful baseline for future patients and can help to detect change.
What treatment is available?

There are three types of treatment available for patients with glaucoma or raised pressure; eye
drops, laser treatment and surgery.
Eye Drops
Most patients will be treated with eye drops. These are usually well tolerated and effective. In
some patients, irritation or sore eyes can be a problem. In this case, there are alternative drops
and sometimes preservative-free treatment which can help.
Laser
Laser treatment can be used as a solution if it is a problem to use eye drops or to supplement
them. Selective Laser Trabeculoplasty (SLT) is now available as first line treatment option to
avoid eyedrops. This treatment is painless, quick and safe. It can be repeated where necessary.
Surgery
For some patients, surgery is the best option. We generally offer glaucoma surgery to patients in
two situations:
• Firstly, where a patient has a pre-existing cataract; we can enhance the surgery to help lower
the pressure and reduce/remove the need for drops. This can be done by inserting a tiny stent (i-
stent) or by doing non penetrating surgery (Viscocanalostomy)which lowers the pressure.
• Secondly, where a patient has a significant risk of visual loss, or where other treatments are
ineffective, we can perform glaucoma surgery (Trabeculectomy/ Viscocanalostomy). Surgery is
performed under local anaesthetic and takes approximately half an hour to 45 minutes.
I have raised eye pressure; do I need treatment?
Not necessarily; some patients can be monitored and may never need treatment. Some may
need treatment later.

If I have glaucoma, will I eventually go blind?

Generally, the answer is NO. With careful treatment and regular care, the vast majority of
patients will keep their vision. Those at highest risk of losing vision are those that develop
glaucoma at a young age (less than 60) and/or those who already have advanced glaucoma
when it is detected.

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