A Guide to Glaucoma

Glaucoma is a group of eye problems that harm the optic nerve. Inside your eye, there's a fluid called aqueous humour. Your eye constantly makes this fluid, and extra fluid goes out through tubes. The optic nerve links your eye to your brain. If the fluid doesn't drain properly, it builds up and increases the pressure inside your eye. This damages the optic nerve over time, and if not treated early, it can lead to vision loss.

The condition often runs in families, meaning if your relatives have it, you might be more likely to get it too. Glaucoma is also more common as you get older and may not show up until later in life. People of African, Caribbean, or Asian origin have a higher risk. If you have other eye issues or medical conditions like diabetes, you might also be at risk. Glaucoma can affect one or both eyes, sometimes more severely in one than the other.

What are the symptoms of Glaucoma?

Just like most eye conditions, people look for early symptoms to determine if they are developing glaucoma. However, glaucoma symptoms are not that easy to identify. Most people with glaucoma experience no symptoms or any type of pain or changes to vision in the early stages. In order to spot such eye conditions, it is important to have an eye test on a regular basis.

In the case of Chronic Glaucoma or Primary Open-Angle Glaucoma, the damage to your vision begins on the outer sections of the eye and moves inwards. If you do not attend regular eye exams with your optician, it may not be spotted until it begins to reach the middle/centre points of your vision. With acute glaucoma – which is very rare – it develops rapidly, triggering a painful build-up of pressure in the eye, causing severe eye pain, red eye, headache, and nausea. This requires urgent medical attention.

Who has a higher chance of having Glaucoma?

Other than inheriting the condition, other factors increase the likelihood of you having glaucoma.

You are more likely to suffer from glaucoma if you are:

• A woman
• Over 40 years old
• Have high myopia
• Have hypertension/high blood pressure
• Diabetic
• Long-sighted
• Family history
• Are on steroid medication

How is glaucoma diagnosed?

Glaucoma can be diagnosed during a normal eye test; the optician will also look at your entire eye and its internal structure. Your optician will perform a series of tests which are quick and painless. Four main tests are performed to help diagnose glaucoma:

Optic nerve assessment

Your optic nerve is the most affected organ when suffering from glaucoma, during your examination, it is photographed using a highly sensitive retinal camera. This is referred to as DRP or digital retinal photography. The images captured will be used as a constant reference during future checks and any changes will be monitored and managed as needed.

Visual field test

During a visual field test, you will be exposed to a sequence of light spots and then asked which ones you are able to see. You should be able to see the dots in your peripheral vision, if you cannot this could be an indication that glaucoma has begun to damage your eyesight.

Eye pressure tests (tonometry)

An eye pressure test uses an instrument called a tonometer. This is required to measure intraocular pressure i.e. the pressure inside of your eye.

OCT (Optical Coherence Tomography)

OCT scans are highly useful for their ability to detect certain conditions up to four years earlier than more traditional scanning and imaging methods. Similar to an MRI scan, it will produce a 3D-like image of the internal structure of your eye. Your optician will monitor and record any visible changes over time.

How is glaucoma treated and is there a cure for glaucoma?

Glaucoma can be treated; however, early detection is important, so any damage to the eye can be greatly minimised or prevented if left untreated, it can get progressively worse.

There is no fool-proof cure, however, early detection and prevention are key for dealing with the condition. Once you have been diagnosed, you will be informed what caused the condition, at what stage your condition has developed and the next course of action.

The most common form of treatment for glaucoma is daily eye drops, that help reduce the pressure in the eyes. You must also continue to attend regular appointments to see your eye doctor who will monitor the condition of your eyes.

Are there contact lenses for glaucoma?

There are no specific contact lenses that are designed to correct the effects of glaucoma. If you suffer from other refractive errors, you may still wear your contact lenses under the supervision and recommendation of your optician.

Can I drive if I have glaucoma?

If you have glaucoma, your driving ability depends on how much your eyes have been affected. As with all eye conditions, you must alert the DVLA if you are suffering from glaucoma or risk a fine. Speak with your optician and discuss whether or not it is appropriate for you to drive if you suffer from an eye condition.

Can you take vitamins for glaucoma?

There is very minimal and mostly inconclusive evidence as to whether vitamins can improve vision or protect against further vision loss. Dietary supplements are a way of maintaining your overall health and should be taken as a compliment to an overall healthy diet.

Can I get a free eye test if I have glaucoma?

Yes, you can get a free eye test if you have or are at risk of glaucoma. Under the NHS you are eligible for a free eye test for glaucoma if:

• You have been formally advised by an ophthalmologist that you are at risk of developing glaucoma.
• You are over the age of 40 and your father, mother, sibling/s or birth child has been diagnosed with glaucoma.
• You have been formally diagnosed by a doctor or ophthalmologist for diabetes or glaucoma.