This is part 2 of an interview done with Dr Pengelly from Underhill Optometry on the subject of Glaucoma- detection and treatment.
Q. How can I tell if I have glaucoma?
With open-angle glaucoma, the most common type of glaucoma, it is painless vision loss. A patient does not notice any changes until it is late stage. That is why it's important to have regular eye exams, as an optometrist will screen patients and assess their risk for glaucoma.
Acute angle-closure glaucoma can have a more dramatic appearance. Symptoms of acute angle-closure glaucoma can be - the eye goes very red, - it is painful- vision goes blurry/fuzzy- patient can see halos around lights - patient can get a severe headache- patient can experience nausea and/or vomiting
Q. How is glaucoma detected?
There are a few different steps to determining whether glaucoma is present. During a regular eye exam, intraocular pressure is checked to make sure it is stable from previous visits (not increasing over time, and not having too much fluctuation). A dilated fundus exam allows the doctor to assess the health of the optic nerve, which is where glaucomatous damage manifests. Additional tests will be done if there are concerns - including measuring the thickness of the cornea, gonioscopy (assesses how easily the fluid drains out of the eye), a visual field test (to check peripheral vision), as well as additional imaging tests such as an OCT or HRT.
Q. How is glaucoma treated?
Standard treatment is that patients are given eye drops to help lower the pressure in the eye. There are many different drops available. Some increase the outflow of the fluid in the eye, some reduce the production of the fluid in the eye, and some will do both. A lot of research has gone into deciding when is the best time to take different drops and at what frequency.
If drops are unable to adequately manage glaucoma, there are additional treatment options - various types of surgery mainly aimed at improving the outflow of fluid from the eye.
Q. Can glaucoma be prevented?
Unfortunately there is no way to prevent open-angle glaucoma. At this point in time, the best solution is regular eye exams. If the disease is caught early, and treatment is initiated, it will help minimize the damage going forward.
Angle-closure glaucoma can have intervention and may prevent damage from being done. Angle-closure happens when the fluid cannot drain out of the eye due to a blockage. If a narrow angle is determined during an eye exam, a prophylactic laser treatment can be done to widen the angle, and try to decrease the chance of having angle closure in the future.