Information about Glaucoma

This page has been written to give you more information about Glaucoma, along with symptoms, side effects and possible treatment plans. Glaucoma is a group of eye diseases in which the optic nerve, which connects your eye to your brain, is damaged where it leaves the eye.

This may be because the pressure is higher than normal, or because the nerve is more susceptible to damage from pressure. This may affect one or both of your eyes. There are two main types of glaucoma – chronic glaucoma, which happens slowly, and acute glaucoma which happens quickly. Chronic glaucoma is much more common than acute glaucoma. The most common form of chronic glaucoma is called primary open angle glaucoma (POAG).

FACT:  Glaucoma is one of the world’s leading causes of blindness. In the UK, about two per cent of the population over 40 have the condition.

Who is at risk of chronic glaucoma?

 Anyone can develop chronic glaucoma. The risk of developing chronic glaucoma increases if you are:

• aged over 40;
• very short-sighted;
• of African or Caribbean origin;
• closely related to someone with chronic glaucoma;
• have raised pressure in your eye – this is called ocular hypertension (OHT);
• are diabetic; or
• have high blood pressure.

Please note:  If one of your parents or children, or a brother or sister, has glaucoma, and you are over 40, the NHS will pay for your eye examination.

Will I go blind if I have glaucoma?

 If left untreated, glaucoma can lead to tunnel vision and blindness. But most people who go blind from glaucoma are those in whom it was detected at a late stage. As a result, it is important to detect it early. Any vision which has been lost to glaucoma cannot be recovered. However, with early diagnosis, careful monitoring and regular use of the treatments, further damage to vision can be prevented. Ultimately, most patients will retain useful sight for life.  While there are usually no warning signs, regular eye tests will help detect the onset of the disease.

How is Glaucoma detected?

Because the early stages of chronic glaucoma do not cause symptoms, it is important to have regular eye examinations. So it can be detected before it affects your sight. Once your sight is lost, it cannot be restored.

There are various tests which help practitioners decide if you have glaucoma. All of which provide information, like pieces of a jigsaw puzzle, to build up an overall picture.

Generally speaking a practitioner will like to measure the pressure of your eyes (IOP’s) as higher pressure correlates to an increased risk of Glaucoma. Next, assessment of the optic nerve is required. Traditionally by direct observation or more recently using scanning technology Optical Coherence Tomography (or OCT). Which is able to pick up damage at an earlier stage. Repeat imaging of the optic nerve is normally required for comparison, which helps track progress and look for changes in the nerves over time.  Visual fields testing is sometimes carried out to assess your peripheral vision. Although this tends to be more affected with advanced Glaucoma. Some practitioners will also assess the angle of the eye where the fluid drains away (this can be done with a technique called Gonioscopy or with an OCT scan).

Please Note: Here at Focus Medical Eye Centre our specialist practitioners hold professional certificates in Glaucoma and can offer full Glaucoma screening including OCT scanning.

FACT: Because the early stages of chronic glaucoma do not cause symptoms, the best way to detect it early is to have regular eye examinations.

What will happen if I have chronic glaucoma?

 If a practitioner suspects that you may have glaucoma, they will refer you to an ophthalmologist (a specialist eye doctor) for a diagnosis. This may involve you having more tests, or repeating some that you have already had. If you have chronic glaucoma, you will be given eye drops to use every day. The drops will reduce the pressure and help control the build-up of fluid. They will not hurt.

Because you will not feel different in any way, you will not be able to tell that the treatment is working. This is why it is very important that you go to your follow up appointments and keep on using the eye drops.

Your ophthalmologist may recommend that you have an operation to reduce or help drain away the fluid. This option is becoming more popular as a treatment plan.

FACT: There is no cure for chronic glaucoma but it can be treated effectively; normally with eye drops or sometimes surgery.

I have glaucoma. Can I drive?

If you drive a car and have been diagnosed with glaucoma in both eyes, this will affect the amount you can see around you. The law says that you must tell the DVLA (Driver and Vehicle Licensing Authority), or DVA if you are in Northern Ireland. You may have to take some extra tests, but most people are still allowed to carry on driving. You can find out more information about Glaucoma and driving at gov.uk/health-conditions-and-driving

Acute glaucoma

This is a type of glaucoma where the drainage channels inside your eye are blocked or damaged in some way. This causes the pressure inside your eye to increase rapidly. It may be called acute angle closure glaucoma.

Sometimes the increased pressure can come and go. And some people get short bursts of pain or discomfort and blurred vision. This can happen when your pupils get bigger, so you may notice it at night or when you are in a dark area (like the cinema) or when you are reading. Other symptoms are an ache in the eye (which may come and go), nausea and vomiting, red eyes, or seeing coloured rings around white lights. Or it can even be a bit like looking through a haze or mist.

If you get these symptoms it is important to act quickly. Even if the symptoms appear to go away. Your vision may be damaged each time you notice the symptoms. Even if you have these symptoms but they have gone away, you should see your optometrist as soon as possible. Always mention that you have had these symptoms. If you have symptoms and they have not gone away, you should go to the Accident and Emergency department immediately so that they can reduce the pressure in your eye and get rid of the pain.

Who is likely to get this?

People who are more likely to get acute glaucoma are:

• people over the age of 40;
• women;
• people of East Asian or South Asian origin;
• people with a family history of closed-angle glaucoma; and
• people who are long-sighted.

For more information about Glaucoma, look it up on the NHS Choices website nhs.uk, or phone SightLine on 01233 648170. Sightline is an information, support and advice service provided by the International Glaucoma Association (glaucoma-association.com).