Consultant surgeon’s guide to glaucoma
Director of Innovation Eye Clinic and Head of Glaucoma at Queen Victoria Hospital, East Grinstead, Mr Gok Ratnarajan explains what we need to know about the Glaucoma.
WHATISGLAUCOMA? Glaucoma is a condition where the optic nerve that carries visual information from the back of the eye to the brain is damaged. The most common cause of glaucoma is high pressure inside the eye.
HOWCOMMONISIT? Glaucoma is the leading cause of irreversible blindness in the UK and worldwide. Around half-a-million people in the UK are currently diagnosed with glaucoma. Probably about that same number have glaucoma but do not know they have the condition because of the lack of symptoms.
HOWDOIKNOWIFIHAVE GLAUCOMA? Glaucoma often does not have any symptoms until the disease is already quite advanced. For this reason, glaucoma is sometimes known as the ‘silent thief of sight’. The peripheral field of vision is often affected first which can be hard to detect without an eye examination. Rarely, the pressure inside the eye can build up very quickly (called an acute attack of glaucoma), this can cause severe pain. If this occurs you should get your eyes examined immediately.
HOWISITDETECTED? Glaucoma can be diagnosed after having a full eye examination where the eye pressure, optic nerve and field of vision are assessed. This can be performed by an optician, who will then refer you to an eye doctor (ophthalmologist) if something suspicious is picked up on the eye examination. Glaucoma is more common as you get older and can run in families. If you are over 60, or have a close family member with glaucoma and you are over 40 you should get your eyes tested with your optician every year, and this is covered by the NHS.
HOWISGLAUCOMATREATED? As glaucoma cannot currently be cured, the key is early diagnosis. For many decades the main treatment for glaucoma was eye drops. In more recent years with the advent of new lasers and minimally invasive glaucoma surgery (MIGS) we now have many more treatment options available.
ANYNEWDEVELOPMENTSOR TREATMENTSINGLAUCOMA? Yes, indeed. New glaucoma lasers and safer, less invasive operations are now available which can often prevent glaucoma getting worse, and results in less patients needing lifelong eye drops. Innovations and advancements in glaucoma treatment is my passion and where a lot of my clinical research is focused. It is really quite exciting to be able to offer safer and more effective treatments. Progress is also being made to further understand the genetics of glaucoma. This may mean we can identify those most at risk of glaucoma even before damage to the optic nerve has occurred. The holy grail is to repair an optic nerve that is already damaged from glaucoma. Although promising stem cell research is underway, no ‘cure’ for glaucoma is available at present.