Glaucoma is an eye condition where your optic nerve is damaged by the pressure of the fluid inside your eye.
Glaucoma may lead to loss of vision and usually is most common in adults in their 70s and 80s, yet it can affect people of all ages.
Types of Glaucoma?
Primary open angle glaucoma (POAG)
This is the most common type of glaucoma. It’s a chronic condition which means the damage to your optic nerve and changes to your sight happen very slowly over time.
Acute angle closure glaucoma
Acute angle glaucoma happens when your eye pressure rises very suddenly. It’s very painful and can causes permanent damage to your sight if it’s not treated quickly.
This is when glaucoma occurs as a result of another eye condition, an operation, injury or medication.
Congenital glaucoma is a very rare condition that affects young babies. It’s usually diagnosed in early years and managed by specialist clinics.
Most people don’t have any symptoms. The first sign is often a loss of peripheral, or side, vision. That can go unnoticed until late in the disease.
Glaucoma doesn’t usually cause any symptoms to begin with. It tends to develop slowly over many years and affects the edges of your vision (peripheral vision) first.
For this reason, many people don’t realise they have glaucoma, and it’s often only picked up during a routine eye test.
If you do notice any symptoms, they might include blurred vision, or seeing rainbow-coloured circles around bright lights. Both eyes are usually affected, although it may be worse in one eye.
Very occasionally, glaucoma can develop suddenly and cause:
- intense eye pain
- nausea and vomiting
- a red eye
- a headache
- tenderness around the eyes
- seeing rings around lights
- blurred vision
Most cases are caused by a build-up of pressure in the eye when fluid is unable to drain properly. This increase in pressure then damages the nerve that connects the eye to the brain (optic nerve). Certain things can increase the risk such as:
- your age – the older you are the more common it is
- your ethnicitiy – people of African, carribean or Asian heritage are at higher risk
- your family history – you are more likely to if you have a family member with the condition
- other medical conditions associated with your eyes or diabetes.
Your eye doctor will use drops to open (he’ll call it dilate) your pupils. Then he’ll test your vision and examine your eyes. He’ll check your optic nerve, and if you have glaucoma, it will look a certain way. He may take photographs of the nerve to help him track your disease over time. He’ll do a test called tonometry to check your eye pressure. He’ll also do a visual field test, if necessary, to figure out if you’ve lost your side, or peripheral, vision. Glaucoma tests are painless and take very little time.
It’s not possible to reverse any loss of vision that occurred before glaucoma was diagnosed, but treatment can help stop your vision getting worse.
The treatment recommended for you will depend on the type of glaucoma you have, but the options are:
- eye drops – to reduce the pressure in your eyes
- laser treatment – to open up the blocked drainage tubes or reduce the production of fluid in your eyes
- surgery – to improve the drainage of fluid
You will also probably need regular appointments to monitor your condition and check the treatment is working.
Glaucoma and clinical negligence
Glaucoma is not easy to diagnose or easy to treat. Despite the best efforts of doctors or optometrists’, the outcome is not always what the patient would hope for. On rare occasions, the standard of treatment received by a patient may fall short of that which the medical profession itself would expect. This could be a failure to carry out the appropriate tests or failure to detect the condition.