Glaucoma is a serious eye condition because it can damage the optic nerve and cause permanent loss of sight if it is not found and treated. The reassuring news is that, with early diagnosis, appropriate treatment and regular monitoring, many people with glaucoma retain useful vision throughout their lives.
The key is not to wait for symptoms. The most common form of glaucoma usually develops slowly and often causes no noticeable warning signs in its early stages.
At Farnham Eye Care, we believe that understanding a diagnosis is an important part of feeling in control. This guide explains what glaucoma is, why it matters and how treatment can help protect your sight.
Glaucoma is the name for a group of eye conditions that damage the optic nerve. The optic nerve carries visual information from the eye to the brain, so it is essential for sight.
In many people, glaucoma is linked to pressure inside the eye being higher than that particular optic nerve can tolerate. The eye continuously makes a clear fluid called aqueous humour. Normally, a similar amount drains away through tiny channels at the front of the eye. If that drainage becomes less efficient, the pressure may rise.
However, glaucoma is not simply about having a “high” eye pressure. Some people develop optic-nerve damage at pressures that are within the usual range, while others tolerate a higher pressure without developing glaucoma. This is why treatment and follow-up are always individual.
Damage from glaucoma cannot usually be reversed. Once nerve fibres have been lost, treatment cannot bring them back.
That is why glaucoma needs to be taken seriously, even when vision seems perfectly normal. Treatment is aimed at slowing or stopping further damage, rather than restoring sight that has already been lost.
Glaucoma is a lifelong condition, but a diagnosis does not mean that blindness is inevitable. With a clear treatment plan and regular monitoring, most people being treated for chronic glaucoma have a good quality of life and do not go blind.
Often, not at first.
The most common type, primary open-angle glaucoma, tends to develop gradually over many years. It may be picked up during a routine eye examination before you notice any change in your vision.
This is one reason regular eye tests are so important, especially as we get older or if there is a family history of glaucoma. A routine sight test can identify concerns that need a more detailed assessment.
Less commonly, pressure inside the eye can rise suddenly. This is different from the usual slow form of glaucoma and needs urgent assessment.
Seek urgent medical help if you develop sudden symptoms such as:
These symptoms can have several causes, but they should not be ignored.
Glaucoma can affect adults of any age, but it becomes more common with increasing age. It can also run in families, so it is worth telling your optician or eye specialist if a close relative has glaucoma.
Other factors, including the shape and structure of the eye, eye pressure, certain medical conditions and previous eye injury, may also influence an individual’s risk. Your eye specialist will consider the whole picture rather than relying on one measurement alone.
No single test gives the full answer. A glaucoma assessment may include:
These tests help us understand whether glaucoma is present, how advanced it is and what eye-pressure target is most appropriate for you.
The aim of glaucoma treatment is to lower eye pressure to a level that gives the optic nerve the best chance of remaining healthy.
The right treatment depends on the type of glaucoma, the amount of pressure reduction needed, the stage of the condition and your individual circumstances. Options can include:
Eye drops are often the first treatment. They may reduce the amount of fluid the eye produces, improve drainage or do both. They are very effective for many people, but they need to be used regularly and can sometimes cause irritation or other side effects.
Laser treatment may be used to help fluid drain more effectively from the eye or to reduce fluid production, depending on the type of glaucoma. For some people, it can reduce the need for drops; for others, it works alongside medication.
Surgery may be recommended when a greater pressure reduction is needed, or when drops and laser treatment are not controlling the pressure well enough. There are several different procedures, from minimally invasive glaucoma surgery (MIGS) to more traditional operations such as trabeculectomy or tube surgery.
The best operation is not the same for everyone. The decision is based on the level of pressure reduction required, the rate at which glaucoma is progressing, the health of the eye and the balance of benefits and risks for you.
For carefully selected patients with mild to moderate open-angle glaucoma, implant-free options such as ELIOS™ laser treatment for glaucoma may be considered. Your surgeon can explain whether a particular procedure is suitable for you.
At present, glaucoma cannot be cured and sight that has already been lost cannot usually be restored. But it can often be controlled.
The most important things are to attend follow-up appointments, use treatment exactly as advised and let your eye-care team know if you are having difficulties with drops or notice a change in your vision. Glaucoma management is a partnership: the treatment plan can be adjusted as your needs change.
If you have been told you have glaucoma, it is natural to feel worried. The practical next step is to understand your own condition: what type of glaucoma you have, what your target pressure is and why a particular treatment has been recommended.
Questions you may want to ask include:
The earlier glaucoma is identified and managed, the more opportunity there is to protect vision for the future.
If you have concerns about glaucoma, raised eye pressure or a family history of the condition, a specialist assessment can give you clarity about your eye health and the options available to you.
At Farnham Eye Care, Professor Dan Lindfield and the specialist team provide individual glaucoma assessment, monitoring and treatment planning. Arrange a glaucoma consultation to discuss your concerns.
