Glaucoma

Glaucoma is an eye disease in which the optic nerve becomes damaged by high pressure in the eye. When the pressure in the eye gets too high, the optic nerve can become damaged, and the visual signals from the eye cannot be processed by the brain. This means that not everything your eyes “see” can be processed. Glaucoma causes vision loss, and if not managed, over time, glaucoma can cause blindness.

Causes of glaucoma

When blocked fluid cannot flow out of the eye abnormally high pressure develops in the eye, affecting the optic nerve. Depending on the cause for the blockage, there are different types of glaucoma including:

• Open-angle glaucoma – this is the most common type of glaucoma caused by a partial blockage in the drainage canals of the eye.
• Angle-closure glaucoma – also called acute glaucoma, this type occurs when the drainage system of the eye is blocked by the iris.
• Normal-tension glaucoma – this is a more rare type of glaucoma that develops without abnormal pressure in the eye.
• Secondary glaucoma – this type occurs when pressure is caused by an eye injury, cataract or diabetes.
• Congenital glaucoma – this type is very rare and develops in infants due to poor development of the eye’s drainage canals during pregnancy.

Symptoms

Depending on the type of glaucoma, symptoms may vary. Many may not even realise they have glaucoma until they have some vision loss. That is whuy it is important to have regular eye checks to monitor the eye pressure. Glaucoma typically causes gradual narrowing of peripheral vision. In advanced stages, symptoms may be more severe, including:

• Severe tunnel vision
• Blind spots
• Headaches
• Eye redness
• Blurred vision
• Nausea and vomiting

Treatment of glaucoma

Glaucoma is a PMB condition which means that all Medical Aid Funds in South Africa are required by law to cover consultations, tests and glaucoma treatments from your chronic benefit. This applies to all plan options, whether you have a medical savings account or not.

Dr York will perform a thorough eye examination to look for signs of glaucoma, including a 3D scan of the optic nerve and testing your visual field and eye pressure. If you are diagnosed with Glaucoma, Dr York will discuss the various modern treatment options to lower your eye pressure and prevent any further damage to your optic nerve.  When caught early, medications can be used to prevent or slow down any further nerve damage or vision loss caused by glaucoma. Medications can either increase the flow of the fluid out of the eye or decrease the production of fluid in the eye, lowering the intraocular pressure. These medications will then be needed on a lifelong basis and are covered through your chronic benefits by all medical aid funds.

In some cases for glaucoma not responding to medication, laser eye surgery known as Laser Trabeculoplasty is performed, in which a laser is used to open the drainage channels of the eye, lowering the eye pressure. If the pressure is still too high then eye surgery such as a trabeculectomy may be considered. During this procedure, a new drain is created in the eye to allow for better flow of fluid from the eye. Newer drainage procedures such as the i-Stent and the Xen implant are showing some promising results. Discuss with Dr York to hear if you may be a candidate for one of these newer drainage procedures.