World Glaucoma Week runs this month from March 9th-15th, so at Envision Optical this month we are concentrating on raising the awareness of this very common and eyesight threatening disease glaucoma. A leading cause of avoidable, irreversible blindness in Australia, glaucoma affects over 300 000 people, and it's estimated that around 50% of sufferers are yet to be diagnosed.
As an independent Gold Coast and Tweed optometry practice focused on eye health care, we want to dispel the myth that glaucoma only affects the elderly, We encourage anyone who may be at risk of developing glaucoma to get their eyes tested, especially if you have a family history as you are 10 times more likely to develop glaucoma if you have a direct relative with this disease.
What is glaucoma?
Glaucoma is a disease where the optic nerve at the back of the eye, which connects the eye to the brain, is progressively decaying. It is most commonly associated with raised fluid pressure inside the eye. The progressive decay of the optic nerve causes a gradual loss of peripheral vision, and if left untreated, the patient will eventually have severe irreversible vision loss in a form of tunnel vision and potential blindness.
What Causes glaucoma?
There are a number of different forms of glaucoma with individual unique causative factors. Many are related to structural changes within the eye that impede the outflow of the internal fluid leading to increased eye pressure. Glaucoma genes have been identified in recent studies, and there has been shown to be a 10 times greater risk if you have a direct relative with the condition. Patients with diabetes, myopia, cardiovascular disease, prolonged steroid use, migraines and previous eye injury or surgery are also more likely to be affected.
What are the symptoms of glaucoma?
There are usually NO SYMPTOMS in most forms of glaucoma, so it is vitally important for everyone to have their vision and eye health check every two years at the least. It is only in cases of extreme high eye pressure that you would experience any pain or discomfort. More than 300 000 Australians have glaucoma, with up to half unaware they even have the disease. In advanced cases of glaucoma, patients can experience tunnel vision.
How do we detect glaucoma?
At Envision Optical our optometrists always perform a thorough examination of the optic nerve health and check your intraocular pressure at every full examination. We recommend Digital Retinal Photography as the best method of recording the optic nerve health to allow for ease of future comparison. It is a change in the nerve structure that makes us suspicious of glaucoma so documenting current health status makes future comparison much more meaningful. If glaucoma is suspected, we will recommend undergoing computerised peripheral visual field assessment, OCT nerve scan, OCT corneal thickness assessment, and gonioscopy. All of these tests give us extra information regarding the likelihood of glaucoma and the result will be analysed before deciding if a referral to an ophthalmologist is required for further specialist treatment.
How is glaucoma treated?
If the results of testing indicate a high likelihood of glaucoma you will be referred to an ophthalmologist for confirmation of the diagnosis and commencement of treatment. Treatment is crucial because you will experience loss of vision and gradually go blind if nothing is done. Most patients are able to be treated by using eye drops which lower the pressure inside your eyes. This has been shown to be an effective treatment to prevent progressive nerve damage and subsequent vision loss. There is no permanent cure. The treatment is ongoing and will require daily instillation of drops, usually for the rest of your life. Initially, follow up testing of peripheral vision and optic nerve scans will likely be done at least every six months to monitor for further deterioration to ensure the drops are working. Our Envision optometry team are able to work co-operatively with your eye specialists to assist in management and even write repeat prescriptions for your eye drops.
Surgical treatment of glaucoma
If drops are ineffective, further treatments by laser or surgery will be considered by your specialist to effectively lower your eye pressure. Laser trabeculoplasty treatment consists of targeting the area of the eye that drains out the fluid to more effectively lower the eye pressure. Several treatment sessions are often required. Surgical treatment involves creating a more effective fluid outlet surgically to ensure adequate pressure control. In extreme cases, drainage valves can be inserted into the eye although this is rare. In the vast majority of cases, eye drops will provide effective pressure control.
What should I do to guard against developing glaucoma?
If anyone in your family develops glaucoma, make sure all family members are aware of their greater risk of developing glaucoma and subsequent vision loss.
You can make sure that you have adequate vitamin C intake along with magnesium, Fish oil and even Gingko Biloba. No matter what: it's good for you anyway!
Most importantly: come in and visit us at Envision for regular eye health checks at least every two years, which includes the monitoring of your optic nerve health with retinal photography, to aid in future comparisons. As with most eye disease, early detection is your best defense!