Glaucoma Treatment

What is glaucoma?

Your eye continually produces a fluid that drains away through a channel at the front. If that drainage is obstructed, pressure builds inside the eye. Over time raised pressure damages the delicate fibres of the optic nerve, and each damaged fibre is a small piece of vision permanently lost.

Damage usually begins in the peripheral (side) vision. Central vision often stays sharp until late in the disease, so people frequently believe their eyes are fine while significant loss is already underway.

Symptoms and warning signs

Chronic open-angle glaucoma, the most common form, typically causes no symptoms at all in its early stages. That is precisely the danger. Later signs include:

• Gradual loss of side vision, such as bumping into door frames or missing objects to the side
• Difficulty adjusting in dim light
• Tunnel vision in advanced disease

Acute angle-closure glaucoma is different and is a medical emergency. It causes sudden severe eye pain, a red eye, blurred vision, haloes around lights, headache, and sometimes nausea and vomiting. Anyone with these symptoms should get to an eye hospital immediately.

Who is at risk?

Glaucoma is particularly common in people of African descent, and it tends to begin earlier and progress faster. Risk is higher if you:

• Are over 40
• Have a parent, brother or sister with glaucoma
• Have raised pressure inside the eye
• Have diabetes or high blood pressure
• Are very short-sighted
• Have had an eye injury
• Have used steroid medication, including steroid eye drops, over a long period

If glaucoma runs in your family, your close relatives should be tested even if their sight seems perfect.

How glaucoma is diagnosed

No single test diagnoses glaucoma. At St Joseph’s Eye Hospital we build a picture from several: measuring the pressure inside the eye, examining the optic nerve head after dilating the pupil, testing your field of vision to map any areas of loss, and assessing the drainage angle at the front of the eye.

Because glaucoma is a long-term condition, these results also become your baseline. Repeating them over the years is how we tell whether the disease is stable or progressing.

Treatment options

Treatment cannot restore vision already lost, but it can protect the vision you still have. The aim is to lower the pressure inside the eye and keep it low.

• Eye drops: the usual first treatment. They work only while you use them, every day, for life. Stopping the drops allows the damage to resume.
• Laser treatment: improves fluid drainage, and in angle-closure glaucoma creates a new drainage route.
• Surgery: creates a new channel for fluid to leave the eye when drops and laser are not enough.

Whichever treatment you have, lifelong follow-up is part of it. Glaucoma is managed, not cured.

Get your eyes checked

If you are over 40, or anyone in your family has glaucoma, book a check even if your sight feels normal. A simple examination now can prevent blindness later. Glaucoma testing is part of routine eye examination at St Joseph’s Eye Hospital Mgbirichi.