About Glaucoma

What is a glaucoma?

Glaucoma refers to a group of eye conditions in which there is a progressive deterioration of a patient’s optic nerve. The optic nerve is the main connection through which the eye transmits information to the brain for processing. If left untreated, slow but progressive damage to the optic nerve occurs resulting in vision loss. Indeed glaucoma is the most common cause of irreversible blindness worldwide.

How do I know I have glaucoma?

Glaucoma is often asymptomatic until it becomes advanced. Glaucoma first tends to affect your side, or peripheral, vision which usually goes unnoticed until the nerve damage becomes so advanced that the central vision is affected. Unfortunately the optic nerve damage and vision loss that occurs in glaucoma cannot be reversed. For this reason early detection and diagnosis of glaucoma is critical so that treatment can be started to prevent further vision loss.

How is glaucoma diagnosed?

As early glaucoma is largely asymptomatic patients need to have regular eye examinations to screen for the early signs of glaucoma. We encourage all our patients to have regular eye examinations with their optometrist for examination of their optic nerve, intraocular pressure measurement and visual field testing, which are the principle ways to detect glaucoma. This advice applies to all patients but especially those who have a family history of glaucoma or those older than 65 as the incidence of glaucoma increased with age. The diagnosis of glaucoma relies on the early detection of optic nerve damage. This can be difficult in the early stages of the disease.

The ophthalmologists at Cataract and Glaucoma Specialists have access to the latest diagnostic equipment for detecting glaucoma before it becomes advanced including:

  • Heidelberg and Zeiss Spectral Domain Optical Coherence Tomography (OCT) to detect early signs of damage to the optic nerve.
  • Zeiss Humphrey Field Analyser.

How is glaucoma treated?

The main way that glaucoma is treated is by lowering the pressure of the aqueous fluid in the eye. Lowering the intraocular pressure (IOP) can slow or stop further damage to the optic nerve and thereby prevent further vision loss and blindness in most cases. As existing vision loss from glaucoma cannot be recovered, early detection and treatment, before the vision loss becomes advanced is critical. Our specialist ophthalmologists aim to make sure their patients have the latest information about their treatment options and collaborates with them to formulate a clear treatment plan.

Glaucoma eye drops

Eye drops have been the mainstay of glaucoma treatment for many years. The doctors at Cataract and Glaucoma Specialists are experienced in prescribing all the available glaucoma drops and regularly attend national and international meetings to stay abreast of the latest treatment strategies.

Laser Treatment

A number of different laser treatments are available for the treatment of glaucoma. Our purpose designed rooms are equipped with the latest Argon, YAG and SLT lasers. All laser procedures are able to be performed in our rooms. SLT laser (selective laser trabeculoplasty) is performed in our rooms as an outpatient procedure. It is a well-tolerated painless procedure that is used in patients who are not responding well to eye drops and because of its good efficacy and safety profile is increasingly being used as a first line treatment for glaucoma to prevent the need for regular eye drops. YAG laser is used in patients who have glaucoma due to a narrowing of the passage the intraocular fluid leaves the eye (angle closure glaucoma). If the fluid cannot flow from the eye it will build, raising the intraocular pressure which can quickly cause nerve damage. In patients with a narrow drainage angle a YAG laser can be used to provide an alternative drainage pathway to prevent the build-up of fluid in the eye. Occasionally patients have glaucoma due to unusual eye anatomy (plateau iris). This sometimes requires treatment with argon laser trabeculoplasty.

Surgical treatments

In a minority of patients medications and laser treatment are unable to adequately lower the eye pressure to prevent progression of glaucoma. In these circumstances our doctors may recommend glaucoma surgery.Our principle glaucoma surgeon Dr Emily Gregory-Roberts is able to offer a full range of glaucoma surgery to our patients including:

* Trabculectomy

* Glaucoma Drainage Implant Surgery

* Microinvasive glaucoma surgery (MIGS) e.g. istent

Cataract Surgery and Glaucoma

Cataract surgery is often associated with a lower intraocular pressure (IOP) after surgery. It can be especially useful in lowering the intraocular pressure in particular forms of glaucoma especially angle closure and pseudoexfoliative glaucoma. Cataract surgery in patients with glaucoma may require special techniques, preoperative and postoperative management. Our surgeons at Cataract Glaucoma Specialists will take the time to ensure you are well cared for during and after surgery and are aware of all of your treatment options

For more information, please see Surgical Procedures For further information about glaucoma, its diagnosis and treatments that we are able to offer, please contact our rooms. Further information is also available from the Glaucoma Australia website: www.glaucoma.org.au.