Glaucoma: Why early diagnosis is important, and what treatments are available to maintain quality of life

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This  blog on Glaucoma and treatment options has been contributed Dr. Salman Waqar, Consultant Ophthalmic Surgeon, Specialist in Adult Glaucoma and Cataract Surgery.

Glaucoma is a term used to describe a group of conditions in which the eye pressure is high, leading to damage to the optic nerve (the nerve that connects our eye to the brain). This can lead to permanent damage to the field of vision. In severe cases can cause tunnel vision and blindness. Even in less severe forms, glaucoma can interfere with independent living and can even affect our ability to drive.

Prevention is the key.

Regular eye exams with your eye specialist, particularly if there is a family history of glaucoma, can detect the condition early.

Fortunately, we now have many very sensitive tests that can diagnose the condition well before it causes any perceptible damage to your vision. These include Visual Field tests and Optical Coherence Tomography scans. Both are done in clinic and only take a few minutes with no discomfort.

Once the diagnosis is confirmed, the key is to lower the eye pressure and preserve vision. While searching for an eye care facility and a Glaucoma specialist, it’s best to look for a location that can offer the comprehensive treatment options shown below and an experienced Glaucoma Consultant, for long term relief and peace of mind.

  • Eye drops: There are a wide variety of eye drops which can be used to lower the eye pressure. They are usually taken once or twice a day but do need to be instilled regularly for the rest of your life.
  • Lasers:
  •  Selective Laser Trabeculoplasty: This is a simple and painless laser treatment that only takes a few minutes to perform and you can go home the same day. It can be done either to supplement the effect of eye drops or to replace them completely. At the time of your consultation, your consultant will discuss how this can help you.
    •  Laser Peripheral Iridotomy: In a particular type of glaucoma (narrow angle glaucoma), a very small channel is created in the iris (the coloured part of your eye) using a special laser. This can not only help lower the pressure but can also prevent future attacks of very high pressure (called acute angle closure glaucoma)
    •  Cyclodiode: If the eye pressure is not being controlled despite best efforts with all other treatment options, this laser can be performed to stop production of fluid in the eye (this is done by a part of the eye called the ciliary body).
  • Surgery: I am trained in all the latest surgical techniques for the treatment of glaucoma. These include:
    •  Cataract Surgery: For some, simply removing a developing cataract can not only lead to improvement in vision but can also lower the eye pressure.
    •  Cataract Surgery with iStent inject implantation: At the time of cataract surgery a very tiny titanium stent can be implanted into the eye which helps to drain fluid out of the eye thus lowering the pressure. This is part of an exciting new type of surgery called minimally invasive glaucoma surgery (MIGS).
    • Cataract Surgery with goniosynechialysis: Sometimes an iStent cannot be safely placed as the drainage angle of the eye is narrow. In such circumstances the drainage area can be opened with a technique known as goniosynechialysis.
    •  Trabeculectomy with antimetabolite injection: This involves creating a flap on the surface of the eye which allows fluid to drain out. A special anti-scarring medication is used to ensure success.
    •  Aqueous Shunt Devices: These devices comprise of a soft footplate connected to a plastic tube. The tube is inserted into the eye whilst the footplate is secured to the surface of the eye and drains fluid out.  Performing either a trabeculectomy or aqueous shunt device insertion is reserved for cases that are not responding to other suitable treatments as listed above.

Early detection and prompt treatment of glaucoma is essential to preserve vision. An ongoing and strong support system surrounding you can make all the difference in living a fulfilling life despite glaucoma.

Choose a location and a doctor that consider individualised treatments to suit your personal needs. This will help you and your family understand and manage the condition whilst also maintaining your quality of life.