World Glaucoma Week

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March 2, 2023

World Glaucoma Week March 12-18, 2023: The World Is Bright, Save Your Sight 

Questions

  1. What is glaucoma?

Glaucoma is an umbrella term for a group of eye diseases where vision is lost due to damage to the optic nerve (communication pathway between the eye and the brain). The two main types of glaucoma are open angle and angle closure.

  1. What are the first signs or symptoms?

50% of people with glaucoma are not aware they have it, thinking they have healthy eyes. Glaucoma is known as the “sneak thief of sight” as there are usually no obvious symptoms in the early stages leaving people undetected until the disease reaches an advanced stage (blindness). A subset of glaucoma, termed acute primary angle closure, can cause a relatively abrupt onset of glaucoma with severe eye pain, blurred vision, haloes around light and nausea or vomiting. 

  1. Are you at risk?

While anyone may develop glaucoma, the incidence increases with age. By age 40 1:200 Australians have glaucoma rising to 1:8 at age 80. Those with a family history of glaucoma in a first degree relative have a 1:4 risk of developing glaucoma rising to a more than 1:2 risk if a first degree relative has advanced glaucoma. Other risk factors for glaucoma include being short- or long-sighted and being on any form of steroid medication (oral/inhaled/cream/joint injection).

  1. How can it impact a person’s daily life?

Although a diagnosis of glaucoma is not life threatening, it can bring about lifestyle changes and fears for the future. Glaucoma can affect our ability to drive safely and there is a standard your vision and visual fields must meet to hold a driver’s licence.

  1. What happens in the long-term if glaucoma is left untreated?

Left untreated, generally peripheral visual field loss develops (silent at the edge of the visual field) which reduces into tunnel vision, then central vision loss and total blindness. The different types of glaucoma have different rates of progression. It is important to stay motivated and take your glaucoma treatment seriously. The crucial predictors for glaucoma success are treatment adherence and regular clinical monitoring.

  1. When should I get tested?

Early detection of glaucoma saves vision. In general, all individuals between 35-40 years should undergo a comprehensive eye examination for glaucoma by an optometrist or ophthalmologist and this should be repeated every 2-3 years until age 60, when it should be repeated every 1-2 years. If you have a family history of glaucoma, start a decade earlier than the age of onset of glaucoma in your affected relative. 

  1. How is it diagnosed?

To confirm a diagnosis of glaucoma involves a comprehensive eye examination by an ophthalmologist. As the peripheral visual field is usually affected earlier than the central vision, only a specialised clinical examination of the eye and diagnostic methods can pick up early cases. It is ideal to diagnose glaucoma in the very early stages before there is any visual field loss.

  1. What are current methods of treating glaucoma?

Currently the only established treatment for glaucoma is to lower eye pressure to a ‘safe’ level. The ‘safe’ level for eye pressure is different for every patient and may change over time. Treatment options to lower the eye pressure vary with the type of glaucoma and include laser, eye drops, and a variety of surgical procedures.

Relatively recent treatment advancements provide promising news for people with glaucoma. The primary treatment for open angle glaucoma is laser following outcomes from the Laser in Glaucoma and Ocular Hypertension (LiGHT) study which found better long-term glaucoma control than initial glaucoma drop therapy over six years. Beyond the initial glaucoma treatment with laser and drops, options for surgical treatment of glaucoma were traditionally invasive surgical procedures but in recent years there have been less invasive surgical options termed Minimally/Micro-Invasive Glaucoma Surgery (MIGS) procedures which allow fluid to drain from the eye by implanting a small device to assist in reducing eye pressure. These procedures can be performed at the time of cataract surgery.

  1. What are preventative measures that can be taken?

While vision loss in glaucoma can’t be reversed, early diagnosis and treatment can delay or halt glaucoma progression. Successful glaucoma management is a lifelong commitment. One of the most important factors in glaucoma management and to protect vision is following the treatment regimen and attending regular follow-up appointments to monitor for glaucoma progression.

 

Dr Michelle Baker ASc(Hons) MB BS PhD FRANZCO is an Adelaide-based ophthalmologist who specialises in cataract surgery and complex glaucoma management drmichellebaker.com.au