Glaucoma

The early symptoms and signs of Glaucoma are easily missed. Glaucoma sight loss is irreversible. Help us to help you catch it early.

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What is Glaucoma

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Glaucoma is the group of diseases that damages the optic nerve of the eye causing a gradual loss vision. The loss of vision is often very gradual and is often not noticed until the disease process is more advanced. Early detection and treatment is therefore essential to protect against serious loss of vision.

The front of the eye is filled with a clear fluid called aqueous. The aqueous flow from behind the iris and drains at the front of the eye through an area in the angle of the eye known as the trabecular meshwork.

The front of the eye is filled with a clear fluid called aqueous. The aqueous flow from behind the iris and drains at the front of the eye through an area in the angle of the eye known as the trabecular meshwork.

‘Normal’ eye pressure ranges from 12 to 22mmHg (millimeters of mercury). Eyes with a pressure above 22mmHg but with no signs of glaucoma are defined as having ocular hypertension. It is not unusual for eyes within the ‘normal’ pressure range to develop glaucoma.

How does Glaucoma affect sight?

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Glaucoma usually begins to affect the peripheral or side vision.

Early peripheral vision is not usually symptomatic as the brain tends to fill in the missing areas in the field of vision. It is only when these areas begin to enlarge that patches of blurry vision or dark areas become noticeable.

Here is a diagram that illustrates how patients with glaucoma perceived their vision.

Can Glaucoma be cured

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Sight is an important contributor to the quality of our lives.

Seeing well enables us to live more independently and enjoy a fuller range of hobbies and activities. There are a range of problems that can occur with good vision. Some of these require the use of glasses or contact lenses; others require different forms of treatments.

With the help of a series of reading material, blogs, videos and talks, I will focus on some of the common problems with sight including presbyopia, long and short-sightedness, astigmatism and cataracts.

How is Glaucoma detected?

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Clinical Examination

 

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There is no specific single test for glaucoma.

The diagnosis relies on accurate investigative tests and the clinical expertise of the professional assessing your eyes. This should include a detailed examination of the front part of your eye (anterior chamber) as well as your optic nerve.

A special lens is used to examine the drainage angle of the eye (Gonioscope).

A check of your intraocular pressure using a device that gently touches the cornea.

Visual Field Testing

 
This test helps detect and monitor glaucoma. A visual field test maps out what your world looks like to you. It measures the area of vision, or how wide of an area your eye can see.It is important when taking this test that you concentrate on the fixation light in the centre and press the button when the blinking test light is seen with your side vision. If you move your eyes to follow or look for the blinking lights, it decreases the reliability of the test and the ability of your doctor to monitor your disease. visual field shows changes that are not noticed by the patient until the damage is severe.

It is important when taking this test that you concentrate on the fixation light in the centre and press the button when the blinking test light is seen with your side vision. If you move your eyes to follow or look for the blinking lights, it decreases the reliability of the test and the ability of your doctor to monitor your disease.

Areas that appear gray or black on the test results reflect areas in your vision that are blurred or missing. If your glaucoma remains uncontrolled, these areas will get darker and larger.

Corneal Thickness Measurement (Pachymetry)

 

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This simple test measures the thickness of the central cornea and is used help adjust for intra-ocular pressure measurements. Generally speaking the thicker the cornea, the lower the true intra-ocular pressure.

Optic Nerve Scanning

This is a highly sensitive objective optical scan of the optic nerve and surround neural structures. Good quality scans can sometimes pick up disease before they are clinically detectable by the doctor! The measurements can be compared over time to detect if the nerve has changed.

Treatment Options

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Laser Treatment

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Selective Laser Trabeculoplasty (SLT) uses a laser that works at very low levels. It treats specific cells “selectively,” leaving untreated portions of the trabecular meshwork intact. For this reason, SLT may be safely repeated.

SLT may be an alternative for those who have been treated unsuccessfully with pressure-lowering drops.

 

Drops Treatment

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SA number of medications are currently in use to treat glaucoma.

Your doctor may prescribe a combination of medications or change your prescription over time to reduce side effects or provide a more effective treatment.

Typically medications are intended to reduce elevated intraocular pressure and prevent damage to the optic nerve.

 

Deep Sclerectomy Treatment

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Deep sclerectomy has a safety advantage compared with standard filtration surgery.

This is primarily because the drainage area is created without entering into the eye.

Meticulous surgical technique is required however the efficacy and low rates of complications, particularly surgically-induced cataract, make this a procedure of choice in suitable eyes.

 

Trabeculectomy Treatment

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In trabeculectomy a full thickness cut into the eye allowing the fluid inside the eye to drain through a flap created from the white of eye (this sclera).

Trabeculectomy is considered the standard operation for glaucoma and works well for the majority of patients. The risk profile is higher than that for deep sclerectomy.

Most patients undergoing trabeculectomy will need their cataract removal prior to or at the same time as their glaucoma surgery.

 

Tube Implants (XEN implant, Ahmed Valve, Baerveldt Tube)

There are a number of different tube implants to help lower intraocular pressure.

These are usually re-served for complex cases such as glaucoma associated with uveitis all in eyes where previous surgery has failed.

Most of the related studies document follow-up for a one year period. In those reports, it shows that in older patients, glaucoma filtering surgery is successful in about 70-90% of cases, for at least one year.Occasionally, the surgically-created drainage hole begins to close and the pressure rises again.

This happens because the body tries to heal the new opening in the eye, as if the opening were an injury. This rapid healing occurs most often in younger people, because they have a stronger healing system. Anti-wound healing drugs, such as mitomycin-C and 5-FU, help slow down the healing of the opening.

If needed, glaucoma filtering surgery can be done a number of times in the same eye.

 

Implant Treatment

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When medicines and laser surgeries do not lower eye pressure adequately, you may benefit from a procedure called filtering microsurgery.

In filtering microsurgery, a new drainage pathway is made in the sclera (the white part of the eye).

The new drainage pathway allows fluid to flow out of the eye and helps lower eye pressure. This prevents or reduces damage to the optic nerve.

 

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Spire Elland Hospital
Elland Ln, Elland, West Yorkshire
HX5 9EB

01422 324069

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contact number

01422 324 069

Your eyes are important, don’t leave it too late, call us today.