Incidence / prevalence
Glaucoma is an eye disease where the optic nerve located at the back of the eye becomes damaged.
It is found in approximately 2% of the population over the age of 40.
It is estimated that more than 500,000 people suffer from glaucoma in England and Wales alone. Studies have demonstrated that half of all cases remain undiagnosed.
The great majority of patients have a chronic (slowly developing) form of the condition (open-angle glaucoma).
In most cases, glaucoma is caused by high pressure inside the eye (intraocular pressure). Without treatment, there is a risk that you will progressively lose vision.
The loss of vision is permanent, but with early treatment, I can minimise the damage to vision. Most patients with glaucoma are not aware they have problems with their vision.
Is it inherited?
Direct relatives of patients with glaucoma have at least a four-fold increased risk of developing the condition compared with those without a family history.
If a member of your family has glaucoma you should be examined by a specialist annually from the age of 40 onwards.
Diagnosis and examination process
If you are over 40 years of age with a family history of glaucoma, you should have regular examinations with an optician; these are free on the NHS. All individuals over 60 years of age are eligible for free NHS eye tests.
No single test accurately detects glaucoma, and your optician should perform the three glaucoma tests as follows:
This is the measurement of eye pressure. Opticians commonly do this by the ‘air-puff’ technique.
Visual field test (perimetry)
This is the formal mapping of the field of vision by a computerised technique. This can identify damage caused by glaucoma and can detect very early changes.
Optic disc examination
The nerve tissue at the back of the eye should be examined with a special instrument to look for signs of damage.
The treatment of glaucoma has developed considerably over recent years. Drugs with fewer side effects are now available, and there are new, less invasive surgical procedures.
The loss of vision in glaucoma is permanent, but with early treatment, we can minimise the damage.
Treatment prevents or slows down the loss of vision in most patients.
Even if you feel your vision seems normal, taking your treatment as directed by your specialist is important. You could be slowly losing vision without noticing.
Currently, all treatments are designed to reduce your eye pressures. This can be achieved by:
The treatment best suited to you should be made as a collaborative decision between you and your ophthalmologist.
Will I go blind?
With early diagnosis, treatment and regular monitoring, it is very uncommon to lose your sight from glaucoma.
Is treatment lifelong?
Yes. We must stabilise your eye pressure which can often be a lifelong process. If using eye drops, you will need to use them every day. There are alternative methods other than eye drops which I would recommend you discuss with your specialist.
Why do I have glaucoma when my eye pressures are normal?
Some people have optic nerves that are vulnerable and susceptible to damage even at an eye pressure that we would consider to be “normal” within the population. Because of this, it’s important that if you are being monitored for potential glaucoma that your specialist does more than just measure your eye pressure. Regularly performing specialist testing and examining your optic nerves is very important to ensure they are not being damaged without you being aware.