What glaucoma is
Fluid is made inside the eye all the time and drains out through a fine filter near the edge of the coloured iris. In many types of glaucoma this drainage is poor and the pressure inside the eye rises — although glaucoma can also happen when the pressure is normal. Over time the optic nerve is damaged, and the field of vision narrows from the edges inwards. [R10]
Who is at risk
The risk rises with age and with a family history of glaucoma. [R10] Our doctors also keep a closer eye on people with high short sight, an old eye injury, long-term steroid use or diabetes. We recommend a glaucoma check for everyone over 40 — and earlier if a parent, brother or sister has glaucoma.
How we check for glaucoma
No single test is enough, so we look at the eye in several ways:
- Eye pressure: measured with a puff-of-air test and with applanation tonometry, a gentle touch test after numbing drops.
- The drainage angle: examined with a special contact lens (gonioscopy).
- Corneal thickness: measured with an ultrasound probe (pachymetry), which helps us read your eye pressure correctly.
- The optic nerve: photographed and scanned with high-resolution OCT.
- Your side vision: mapped with an automated visual-field test (Humphrey perimetry).
Repeating the visual-field test over the years shows us whether treatment is working.
Treatment options
Eye drops are the most common treatment, and most people need them for life. Using them every day, exactly as prescribed, is the single most important thing you can do for your sight. Laser treatment can improve drainage — for angle-closure glaucoma, a tiny laser opening in the iris (YAG iridotomy) is often advised in both eyes. When drops and laser aren't enough, an operation can create a new drainage channel (trabeculectomy). [R10]
When to get help urgently
Come to hospital immediately if you have sudden severe eye pain, a red eye, blurred vision, rainbow-coloured rings around lights, headache, or nausea and vomiting. This can be an acute angle-closure glaucoma attack — an emergency. [R10]
Who treats glaucoma here
Dr. Praveen Kumar
Consultant Ophthalmologist
Questions patients ask
Can glaucoma be cured?
Sight that has already been lost can't be restored, but treatment can usually stop or slow further damage. [R10]
My eye pressure is normal. Can I still have glaucoma?
Yes. That's why we also examine the optic nerve and test your side vision. [R10]
Do I have to use drops forever?
Usually, yes. If you stop without advice, the pressure can rise again without you noticing anything.
My parent has glaucoma. When should I be checked?
Now — and then as often as your doctor advises. A family history raises your risk. [R10]
References
[R10] American Academy of Ophthalmology, Primary Open-Angle Glaucoma Preferred Practice Pattern (2020); National Eye Institute, NIH: Glaucoma (https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/glaucoma).