Level 4, 187 Macquarie Street
Sydney NSW 2000
Phone: 02 9247 9972
Fax: 02 9232 3086
Email: patientservices@eyeassociates.com.au

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GLAUCOMA

Glaucoma refers to a group of conditions that damage the optic nerve, which is the critical link between the eye and the brain. Loss of neurons (a type of cell in the central nervous system vital to relay information) in the optic nerve leads to irreversible loss of vision with a small percentage of those affected progressing to blindness. Peripheral vision is most commonly affected early in glaucoma. Approximately 50% of individuals with glaucoma are unaware they have the condition.

How is Glaucoma Detected?

By taking a careful history from you, by assessing your optic nerve structure, by measuring your eye pressures, by checking the state of the drain that works to control eye pressure and by performing visual field tests as required, Your Eye Associates ophthalmologist will be able to determine whether or not you have glaucoma as well as your risks to develop it in the future.

If glaucoma is suspected or needs to be excluded, a typical assessment includes:

  • A history to determine your individual risk
  • Ocular examination including eye pressure measurement, gonioscopy (to assess the state of your eyes’ internal drain) and optic nerve examination using a handheld lens and slit lamp.
  • Central corneal thickness measurement: after the surface of the eye is numbed with an anaesthetic eye drop, a small ultrasound probe gently touches the surface of the eye (cornea) and measures its thickness within a few seconds.
  • Automated Perimetry: this assesses both central and peripheral visual field areas. Once positioned comfortably, you look into a bowl-shaped screen and fix your gaze on a central orange light while smaller white dots of light of varied intensity come and go in your vision. You press a handheld button each time you see a white light and your responses are recorded by a computer. Eyes are tested one at a time; the total testing time for both eyes is approximately 15 minutes.
  • Optic nerve imaging: a number of non-contact methods are available and are often used in combination. These include optic nerve stereo photography, optical coherence tomography (OCT; uses reflected light to measure the optic nerve and its surrounds) or Heidelberg retinal tomography (HRT; uses a scanning laser to measure the optic nerve). These tests can be completed within a few minutes but on occasion require the pupils to be dilated to obtain the best results.

How is glaucoma treated?

Glaucoma treatment aims to maintain your quality of life by preventing progression of the disease and any further damage to your vision. We achieve this for you by modifying general health factors as needed and most importantly by reducing eye pressure, even if that pressure is not above the usual range at the time of diagnosis. There are three main strategies to reduce pressure, medical, laser or surgical treatments. The choice of treatment takes into account the likely benefits for you, balanced against possible side effects or harm. Management strategies are different for every patient and may need to be modified for an individual patient over time.

The greater the visual damage, the lower the eye pressures need to be maintained. Eye drops, laser treatments to the drain of the eye and a variety of surgical interventions are available, depending on your needs. Your Eye Associates ophthalmologist will discuss the benefits and possible side effects of each strategy that is relevant for your care.

Ongoing successful management requires regular reviews with repeated eye pressure measurements as well as assessments of your visual function (with one of the visual field technologies that Eye Associates offers) and of your optic nerve structure (with one of the measurement devices available at Eye Associates).

Eye Associates follows a strong policy of patient empowerment to optimise outcomes for our patients. This is based on open dialogue and meaningful communications.

Further reading

Glaucoma: How to Save Your Sight! By Ivan Goldberg & Remo Susanna Jr

Available from www.kugler.com or from www.amazon.com