GLAUCOMA
DR MARINA SYRIMI EYE CLINIC
What is glaucoma?
Glaucoma is a condition where the optic nerve, which connects the eye to the brain, is progressively damaged leading to reduction and loss of the visual field. The damage, in most of the types of glaucoma is gradual and usually starts at the periphery and progresses centrally. The eye is filled with aqueous and vitreous humour to main a centre pressure and shape. This encourages the refracted light to be focused on the retina. In glaucoma the optic nerve is damaged by the pressure of the fluid inside your eye. This may be because the eye pressure is higher than normal, or because of a weakness to the optic nerve.
Types of glaucoma
The most common type of glaucoma is called primary open angle glaucoma. In this condition the eye pressure (intraocular pressure) is above the normal leading to gradual irreversible damage of the optic nerve over the years. The patient is initially unaware of the peripheral visual field defects which are only identified up by formal visual field examinations.
Other types of Glaucoma:
- Normal tension glaucoma – This usually affects about 10-20% of the patients with glaucoma. In normal tension glaucoma the intraocular pressure is within the normal limits. In these patients the optic discs is susceptible to blood pressure fluctuations. This type is often linked to migraines and hypotensive episodes.
- Primary angle closure glaucoma – This is when the drainage angle between the iris and the cornea closes. Blockage of the drainage causes the eye pressure to rise. If the eye pressure remains high for a period of time it leads to optic nerve damage. Angle closure glaucoma can be acute or chronic. Acute Angle Closure is an ophthalmic emergency. The symptoms are:
- Intense pain
- Halos around lights
- Sore/ tender area
- Red eye
- Headaches
You should seek medical advice as soon as possible if you have any combination of these symptoms.
- Congenital Glaucoma - it is a rare but serious type of glaucoma. It usually presents with watering and photophobia.
- Secondary glaucomas - These are usually caused by another eye problem such as iritis, retinal detachment.
Diagnosis
For glaucoma assessment and monitoring you will be asked to perform visual field examination. Then the vision will be taken and the eyes will be examined on the slit lamp. Finally an OCT image will be taken to assess the retinal nerve fibre layer. Confirmation of glaucoma diagnosis often requires multiple clinic visits.
Management of glaucoma
The mainstay of glaucoma management in adults is the administration of ophthalmic drops. These work in various mechanisms to reduce the eye pressure thus aiming to reduce the damage caused at the optic nerve. Each bottle should be changed every 4 weeks. And should never be stopped without consulting their ophthalmologist.
Other treatment options include
- Laser – Selective laser trabeculoplasty, cyclodiode laser
- Surgery in the form of trabeculectomy or tube surgery. The minimally invasive glaucoma devices are recently gaining a lot of interest.
Living with glaucoma
The prompt diagnosis and management of the eye pressure significantly delays progression of glaucoma. Most patients with glaucoma continue to drive when the diagnosis is performed early.
Is it hereditary?
Primary open angle glaucoma is hereditary. First degree relatives are 6 times more likely to develop glaucoma compared with those without family history. Relatives with family history of glaucoma should have a routine eye pressure check annually after 40 years of age.
Useful Resources
- What Is Glaucoma? Symptoms, Causes, Diagnosis, Treatment - American Academy of Ophthalmology
- Glaucoma and Ocular Hypertension - Royal College of Ophthalmologists
- Understanding Glaucoma - RNIB
- glaucoma.uk
CONTACT US
DR MARINA SYRIMI EYE CLINIC
25-552215
DR MARINA SYRIMI EYE CLINIC
KIrzis Centre, 44-50 Emmanuil Roidi,
Block A, Office A35
Limassol 3031
tel. 25 552215