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Worried about glaucoma?

By Faye on 2017-04-27

I read the news this morning on the latest update from a clinical trial, phase 1 of which began in 2015, looking into new ways of helping to detect the eye disease glaucoma.

What's great about research and evolving health care is that we are now able to find and treat things so much earlier; with eyesight this helps to reduce sight loss - which is a great thing.

You too may have read in the newspapers or watched on the news about this new test. It’s being developed with the aim of detecting problems earlier: to allow treatment to be given earlier, before symptoms of sight loss.

This DARC test (detection of apoptosing retinal cells) – meaning finding cells at the back of the eye which are dying – is not yet available as it is still undergoing clinical trials, having been tested for safety on just 16 people so far, however it is something that certainly looks exciting for the future and we look forward to learning the results of phase 2 of the trial in due course.

Already today, I’ve had several clients asking me about glaucoma, as it has been in the news quite a lot lately, so I thought I would put a quick blog post together with some information for those of you who might be interested in learning a bit more about this common cause of sight loss.

The College of Optometrists designed an information leaflet on glaucoma which is a great short guide and I have used some of this information in this blog (they’ve assured me this is okay as I am a member of the College and Mum (optometrist Angela) is a fellow!)...

What is glaucoma?

Glaucoma is a group of eye diseases in which the optic nerve (which connects your eye to your brain) is damaged by the pressure of the fluid inside your eye. This can happen if the pressure in your eye becomes too high or if your optic nerve is more susceptible to damage from pressure. Glaucoma can affect one or both of your eyes. There are two main types of glaucoma: chronic glaucoma which happens slowly; and acute glaucoma which happens quickly. Chronic glaucoma is much more common than acute glaucoma.

Who is at risk?

While glaucoma can affect people of all ages (even children), it is more common in people over 40 years of age.

The risk of developing chronic glaucoma increases if:

  • You’re over 40 years old
  • Are very short-sighted
  • Are of African or Caribbean origin
  • Are closely related to someone with chronic glaucoma (siblings/parents/children)
  • Have raised pressure within your eye – this is called ocular hypertension

 

How is chronic glaucoma detected?

The early stages of chronic glaucoma do not cause symptoms; this means the best way to catch it early is to have regular eye examinations. A person with glaucoma may well notice blurring around the outside of their vision, but this is usually when glaucoma is well advanced. Catch it early to give the best chance of avoiding this.

There are several ways our Optometrists look for chronic glaucoma, these include:

Looking at the back of your eye: This can be done using an ophthalmoscope (shining the light in the back of your eye), on a slit lamp (the microscope we use and hold the little lens up in front of your eye) or taking a wide-field photograph or a scan of the optic nerve: this is so useful for future visits as we can look at previous scans to help detect early signs of change.

Measuring your eye pressure: We use the gold standard (the best!) instruments for measuring intraocular pressure during our eye examinations, the same instruments used by glaucoma consultants in eye hospitals. This allows a quick, painless and importantly accurate measurement of your eye pressure.

Peripheral vision: a visual field test checks how far you can see around you when you are looking straight ahead.

Sometimes you can have chronic glaucoma even if you have normal eye pressure, which is why you will usually have at least two of these three tests during an eye examination. If the results are not clear you may be asked to do one or more of the tests again on a different day.

What is ocular hypertension?

If you have been told that the pressure inside your eye is high, but you do not have glaucoma, it is likely that you have ocular hypertension. Some people naturally have eye pressure that is above the normal range, but this pressure does not cause any damage to your eyes. This means you do not have glaucoma, although, it can increase your risk of developing chronic glaucoma in the future so you will require regular eye examinations to monitor your eyes.

What will happen if I have chronic glaucoma?

If our Optometrist’s suspect that you may have glaucoma, they will refer you to see an eye specialist. If you have chronic glaucoma the most common treatment is eye drops to use every day. The drops are to reduce your eye pressure and help control the build up of fluid inside the eye.

Because chronic glaucoma causes no symptoms at first, if you are at risk you must have regular eye examinations to detect it early, and during your treatment because you will not feel different you will not be able to tell if the treatment is working – this is why it is very important to attend your follow-up appointments regularly and continue to follow all treatment as prescribed. Let us know if you have difficulty putting your eye drops in so we can help with your technique.

In some cases the eye specialist may recommend an operation to help drain the build up of fluid.

Currently, there is no cure for chronic glaucoma but it can be treated effectively, most commonly with eye drops. Any existing eye damage will probably be permanent, but your sight could get much worse if you stop your treatment. It is very important that you use your eye drops as prescribed, even if you cannot tell that they are helping.

I have glaucoma. Can I drive?

If you drive a car and have been diagnosed with glaucoma in both eyes, this will affect the amount you can see, and the law says that you must tell the DVLA. You may have to take some extra tests, but most people are still allowed to carry on driving. You can find out more at www.direct.gov.uk/driverhealth

Acute glaucoma

This is a type of glaucoma where the drainage channels inside your eye become blocked or damaged in some way. This causes the pressure inside your eye to increase rapidly.

Sometimes the increase pressure can come and go, and some people get short burts of pain or discomfort along with blurred vision. This tends to happen more when your pupils get larger – which happens at night or when you are in a dark area.

Other symptoms include an ache in the eye which comes and goes, red eyes, or seeing coloured rings around white lights, or it can seem a bit like looking through a haze or mist.

If you get any of these symptoms it is important to act quickly, even if the symptoms appear to go away, as your vision may be damaged each time these symptoms occur.

If you have these symptoms but they have gone away you should see your Optometrist as soon as possible and let them know you’ve had these symptoms. If you have these symptoms (pain, red eyes and misty vision) and it does not subside you should attend eye casualty immediately for an eye pressure check so that the pain and the pressure in the eye can be relieved.

Risk factors for acute glaucoma include: age over 40 years, women, people of East or South Asian origin, family history of closed-angle glaucoma, people who are longsighted.

For more information, please talk to our Optometrist’s at your appointment, you can make an appointment by calling us on 01642 483611 or contact us here. You can look up glaucoma on the NHS choices website www.nhs.uk or phone SightLine – an information, support and advice service provided by the International Glaucoma Association, on 01233 648170 or visit www.glaucoma-association.com

Take care, eye care

Faye