Glaucoma Treatment at OKKO Eye Specialist Centre

What is glaucoma?

Glaucoma or open-angle glaucoma (OAG) is a condition in which the optic nerve, the structure responsible for transmitting information from the eye to the brain, becomes progressively damaged.

Glaucoma causes a gradual loss of the optic nerve fibres, which slowly affects the eye and vision over time. The peripheral vision is usually affected before the central vision. In advanced glaucoma, patients can be left with “tunnel vision”.

Early detection of glaucoma is critical for preventing vision loss. However, there are often no apparent symptoms in the early stages of the disease. Your specialist can conduct testing to help diagnose glaucoma and can provide treatment to help slow its progression.

Damage to the optic nerve is most commonly caused by high pressure within the eyeball, known as intraocular pressure. Intraocular pressure is determined by the eye’s fluid production called aqueous humour and the drainage of this fluid into the bloodstream via specialised tissue.

The body regulates this fluid’s production and drainage; however, with OAG, this balance is not adequately maintained, and intraocular pressure increases as a result.

Other risk factors for glaucoma include older age, a positive family history, diabetes, higher short-sightedness and previous trauma to the eye.

Early detection is critical for preventing severe vision loss, so you mustn’t wait for symptoms before getting tested for glaucoma.

Glaucoma testing may include a non-invasive examination of the optic nerve using a special microscope and scanning devices, a measurement of the intraocular pressure, and a computerised visual field test to measure peripheral vision.

A positive diagnosis can be difficult in the early stages, and multiple tests are usually required. If your specialist cannot make a definite diagnosis, your eye care practitioner may elect to monitor you closely over several appointments with repeated testing before commencing treatment.

Glaucoma treatments attempt to lower the intraocular pressure of the eye to prevent further progression. Still, they are unable to reverse any optic nerve damage or vision loss that has occurred. This is why early detection is so important.1

The current first-line treatment for glaucoma is eye drops. Most glaucoma medications are safe to use and have minimal ocular and systemic side effects.2

Sometimes more than one drop is required to stabilise the intraocular pressure, and dosing varies from once a day to three times a day.

Sometimes, more than one type of anti-glaucoma medication is required to control your intraocular pressure adequately. This kind of treatment is usually an ongoing commitment for life.

Other treatment options for glaucoma include laser and, in more advanced cases, surgery.

Selective Laser Trabeculoplasty (SLT) is a special laser applied to the trabecular meshwork in an attempt to improve the outflow of aqueous fluid. SLT can be considered a first-line treatment in suitable patients or if a patient has had a suboptimal response to anti-glaucoma medication or is not tolerating the eyedrops.

SLT is considered low-risk3; however, you may require more than one treatment for maximal effect. The efficacy of SLT may also reduce over time, and some patients still need ongoing medical therapy (eye drops) despite SLT treatment.

Your specialist will only consider treating advanced glaucoma with surgery and/or if medical therapy or laser have been insufficient in stopping the progressive optic nerve damage and/or vision loss.

There are numerous surgical options for OAG, including but not limited to insertion of small minimally-invasive stent-like devices to help encourage drainage of the aqueous humour from the eye, tube insertion, or trabeculectomy surgery. Your specialist can discuss these options further with you.