Glaucoma is a disease that damages the optic nerve, resulting in a gradual constriction of the peripheral field of vision. Early glaucoma is not appreciable by the patient, however once vision is lost it can not be restored. Regular screening for glaucoma by your optometrist is advisable after age 45, especially if you have a family history of glaucoma. Once glaucoma is suspected then referral to an eye doctor is recommended. The pressure in the eye is usually raised in glaucoma and there is often a family history.
My glaucoma practice follows the latest NICE guidelines. I routinely measure corneal thickness which is an important risk factor for glaucoma as well as measuring the eye pressure, performing gonioscopy (examining the drainage channels), assessing the optic nerve and measuring the peripheral field of vision. OCT scanning of the optic nerve is routinely performed for baseline assessment and follow up.
Early treatment of glaucoma and regular follow up should prevent loss of sight. Most glaucoma progresses very slowly and with modern treatments significant loss of vision is rare. Treatment involves daily eye drops in most patients, these work by reducing the eye pressure, either by decreasing production or increasing drainage of the fluid in your eye. Drops do have side effects in some patients and if not tolerated there is the option of laser surgery (trabeculoplasty or iridotomy). If the pressure is not adequately controlled then surgical trabeculectomy is offered, this procedure involves creating a channel to bypass the blocked drainage system of the eye, fluid passes through the channel to a small reservoir under the white (conjunctiva) of the eye. The International Glaucoma Association is a patient based organisation and provides more information.