Glaucoma and Glaucoma Surgery
Glaucoma
What is glaucoma?
Glaucoma is one of the world’s leading causes of blindness. It is not curable, but blindness is preventable if the glaucoma is diagnosed and treated early enough. While there are usually no warning signs, regular eye tests will help detect the onset of the disease.
Glaucoma is usually a result of raised intraocular pressure. This causes damage to the intraocular nerve at the back of the eye. Initially, there is a loss of peripheral vision, and later central vision is lost when the disease is advanced. It is important to pick up glaucoma early to prevent central vision loss. Glaucoma may also be caused by Pseudoexfoliation, Pigment, Neovascularization, Inflammation and Trauma.
- Congenital glaucoma (buphthalmos) - this is a condition where glaucoma is present from birth. An increase in the pressure within the eye causes it to enlarge.
- Open-angle glaucoma – this form is usually primary, but may be secondary, acute or chronic. It usually affects both eyes and develops slowly so that loss of sight is gradual. There is no pain, redness of the eye or dramatic change in vision.
- Angle-closure glaucoma, also known as narrow-angle glaucoma – this is a condition where the flow of the aqueous humour fluid is blocked. It may be primary or secondary, acute or chronic. The buildup of the fluid if acute, causes the pressure to rise and cause severe pain with a sudden decrease in vision.
FAQ
Very often, there are no symptoms. For this reason, it is essential that you go for a yearly comprehensive eye examination so that the ophthalmologist or the eye specialist can monitor any changes that may arise in your vision. People who have glaucoma often experience no symptoms; however, some of the symptoms may be:
- A gradual loss of the peripheral vision which may affect both eyes
- Eye pain which may be severe and may be accompanied by nausea or vomiting (acute)
- Blurred vision (acute)
- Red eyes (acute)
- Lights seem to have an extra halo-like glow around them (acute)
- During the advanced stages, you may have a tunnel vision.
- Unexpected or sudden vision problems especially when there is poor lighting
There are various types of glaucoma treatment which include glaucoma eye drops, microsurgery, laser treatments and other eye surgery such as implanting drainage devices.
It’s important to note that the goals for glaucoma treatments are to reduce the intraocular pressure and to prevent any additional vision loss. Depending on the type of glaucoma you have been diagnosed with and the severity of glaucoma, Dr Beatty will prescribe medical treatment, surgery or a combination of both.
Glaucoma Surgery
What is glaucoma surgery?
Glaucoma is a disease in which the optic nerve is damaged, leading to progressive, irreversible loss of vision. It is often, but not always, associated with increased pressure in the eye.
The nerve damage involves the loss of retinal ganglion cells in a characteristic pattern. There are many different sub-types of glaucoma, but they can all be considered a type of optic neuropathy. Raised intraocular pressure is a significant risk factor for developing glaucoma (above 22 mmHg). Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.
What types of glaucoma surgery are done?
Glaucoma surgery is an essential treatment option for moderate to severe glaucoma as it is used to help prevent any further vision loss. In some occasions, it may improve vision.
Your eye specialist will prescribe eye drops or oral medication to help decrease the pressure in your eye, and if the drugs or eye drops don't work, then surgery will be recommended.
The types of glaucoma surgeries include:
- Laser trabeculoplasty: During this procedure, the eye specialist will use a laser to help increase drainage through the trabecular meshwork.
- Drainage tubes and devices: There are different types of drainage tubes and devices used to treat glaucoma, which mostly works by facilitating the outflow of aqueous fluid to reduce the pressure. Most commonly performed procedures for advanced glaucoma are trabeculectomy or insertion of a tube (for example Ahmed or Molteno) or valve (Express).
- There are also MIGS or micro-invasive glaucoma surgeries which also use devices to help lower the pressure.
What to expect after a glaucoma surgery?
After the surgery, your eyes may be red, sore and watery and may have a little bump or swelling where the incision was made. You may also experience blurry vision for some time. Surgery usually doesn’t improve vision, but it aims to stop glaucoma from progressing.
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