Glaucoma is the progressive deterioration of the optic nerve causing changes to the edges (periphery) of your vision. Glaucoma is monitored by your optometrist by checking your eye pressure, scanning your optic nerve, checking your peripheral sensitivity (Visual fields testing) and assessing your eyes with their microscope (slit lamp). Risk factors for developing glaucoma include family history, medications (particularly steroids), ethnicity, sleep apnoea, age and trauma.
The two main types of glaucoma are open or closed angle and are related to the individual structure of your eye. Open angle means there is no physical barrier to the fluid flow within the front section (anterior chamber) of the eye. Closed angle means the structures of the eye are very close together, creating a physical barrier that reduces the outflow of fluid resulting in an increase in the pressure inside the eye.
Eye pressure is one concern with glaucoma diagnosis, but high eye pressure does not mean glaucoma is present. Raised eye pressure (ocular hypertension) can be present in a normal eye and further assessment of the eye is required to provide a definitive diagnosis. On the other hand, eye pressure can be normal in a patient with glaucoma. However glaucoma is primarily treated by lowering eye pressure with eye drops, laser or surgery.
If medicated eye drops are not controlling glaucoma, referral to an ophthalmologist is appropriate. Procedures can be performed in their office to improve the outflow of fluid through the eyes. These procedures include laser peripheral iridotomies (LPI) for closed angle glaucoma and selective laser trabeculoplasty (SLT) for open angle glaucoma. Cataract surgery is also a common treatment method for glaucoma, as the removal of the cataract improves the fluid outflow within the eye thus lowering the pressure. Surgical innovations have also meant that stents (Minimally Invasive Glaucoma Sugery - MIGS) can be placed within the eye to ensure the fluid flow outflow is increased.
Your optometrist will always screen and assess your eyes for glaucoma risk. Further testing may be necessary if you exhibit any of the risk factors or have a strong family history. These tests may include OCT scans and visual fields testing. Please call and make an appointment for an ocular health check with our local optometrist here at The Eyewear Shop and we will happily discuss your glaucoma risk profile.