Patient Information

What is glaucoma? How can it be prevented?

Glaucoma consists of a group of eye diseases characterised by damage to the optic nerve due to high eye pressures, resulting in progressive and irreversible loss of vision. It is the second most common cause for blindness worldwide, and has no symptoms.

Glaucoma cannot be prevented; however, timely medical intervention can slow down its progression so as to prevent any functional impairment and blindness.

Since glaucoma has no symptoms, it is important to visit your eye doctor regularly, so that the disease may be detected early. The tests for glaucoma screening are painless, and your doctor will recommend a routine test for vision and eye pressures. If indicated a visual field examination may also be required. You may also be advised to get a test to determine the thickness of the nerve fibre layer called the Optical Coherence Tomogram (OCT), and a gonioscopy.

In case you are diagnosed with glaucoma, the frequency of your eye exams will be decided by your doctor depending on disease severity and progression.

What puts me at risk for glaucoma?

Everyone above the age of 40 should get an annual eye check, and especially so in case of the following risk factors:

Family history of glaucoma
History of eye injury
Taking steroid medications for any disease
Diabetes, or thyroid disease
History of migraines and vasospastic disorders like Raynaud’s disease
Sleep apnea
Alzheimer’s disease.
Being nearsighted or far sighted (Hypermetropia and Myopia)
Symptoms like frequent change on power of glasses, coloured haloes, headaches and nausea, blurring of vision

It is important to remember that vision loss due to glaucoma is irreversible; you can’t get your vision back once it is lost. Therefore, regular eye exams are mandatory, at least every couple of years if you are over 40 or on the schedule recommended by your doctor.

See more: https://www.youtube.com/watch?v=03hsgEFqe-k

What is a glaucoma check up like?

On the day of your appointment, you will need to bring all your previous records, eye drops and current prescription glasses. It is better to carry your entire medical file, and not only your eye records. Prior to your consultation with your Ophthalmologist, you will be seen by an Optometrist who will perform an initial assessment of vision and eye pressure. Thereafter your doctor will perform the preliminary eye test, including a retinal and optic nerve exam, and schedule further tests if required. These can include visual fields, water drinking test, OCT, pachymetry and a dilated eye exam.

Following these tests, the doctor will explain the results and discuss the further treatment plan with you.

It is better to not drive to the clinic as your eyes may be dilated which will blur your vision clearly for approximately three hours. Also you will not be able to read fine print for this duration. Please bring a pair of sunglasses with you so as to avoid glare on your way back from the hospital.

I have glaucoma. Will I go blind? How effective is the treatment?

With proper medical care, glaucoma blindness can be avoided. In most cases, if you take your eye drops as told, and are regular with your eye exams, you should retain your vision for as long as you live.

In case your glaucoma has been detected late, or has progressed to an advanced stage, your doctor might advise surgery to prevent progression. In case your glaucoma has advanced to a stage that your visual field is severely constricted, you will be offered low vision aids which can aid mobility.

It is always advisable to discuss with your doctor the lifestyle changes that will help you cope with the disease better.

I have glaucoma. How often should I see my doctor?

Doctors recommend an annual eye examination for everyone whereas an examination every alternate years is mandatory for those above 40 years of age. In case you are a glaucoma suspect, your doctor will schedule annual glaucoma tests, and more often in case he/she thinks that is more appropriate.

As for any other chronic disease, you will require lifelong follow up and treatment modification depending on the evolution of the disease process. The doctor will initially need to see you more often so as to determine both disease severity and response to treatment. The frequency of your visual field testing will also be dependent on the same factors.

Once your diagnosis and treatment regimen are sorted, your visits will largely be dependent on disease severity and eye pressure control.

More severe cases with poor control will require more frequent follow up, as compared to early glaucomas.

In case you need a glaucoma surgery, you will require early post-operative care which will be more intensive, and slowly the visits will become more infrequent. It is essential to remember that even after surgery you may require eye drops, and even if your eye pressures are well controlled, regular visits, as scheduled by your treating eye doctor, are mandatory.

What can I do help my parent/partner who has glaucoma?

The diagnosis of glaucoma can be scary for most people because of the implied threat of blindness. It is therefore important for you as a partner/ child/ caregiver to reassure your loved one of the fact that with timely intervention, blindness is not an imminent threat. Emotional support from the family at the time of diagnosis, and thereafter, is essential to help the patient cope with the disease.

You can also help your parent or partner to establish a regular schedule of eye drops. Given that glaucoma is a chronic disease, which requires regular monitoring and lifelong use of eye drops, you can help by acting as a reminder service.

Helping the patient keep his/her scheduled appointments with the doctor is also important, you can drive him/her to the hospital and help schedule the visits as well.

In case the patient is already suffering from a visual loss that impairs his/her daily activity, then the support of the family becomes imperative. It is important to remember that assistance is available from other support groups as well, and you should discuss with your doctor the possibilities for visual rehabilitation and low vision aids.

What does loss of vision due to glaucoma feel like?

Unfortunately for those who need to treat and diagnose glaucoma, the patient has no symptoms, and even advanced field defects may go unnoticed by the patient since the brain compensates for the peripheral loss. This sometimes means that patients do not take their field loss seriously, forgetting both their medication and doctor visits.

MSD pharmaceuticals, International Glaucoma Association (IGA) and Moorfields Eye Hospital have helped develop a free glaucoma Sim App for healthcare professionals and patients. The App helps you to simulate the effect of glaucoma on visual field over time. You can thus experience a simulation of the loss of vision that can be a result of glaucoma progression.

The App is available from the UK Apple Store. To download it, please search for ‘Glaucoma SIM’.

How do I decide on a doctor? What about second opinions?

Choosing a doctor is often tricky, since you are apprehensive about your vision, and will be inundated with information from the internet and friends alike. Personal references are often a good source of information, and it is sensible to a background check about your doctors’ credentials online.

Find a doctor who listens and responds to your concerns and questions. Your doctor also must explain your treatment options, and should be available and accessible for frequent check ups. If you are not comfortable with your doctor, it is a good idea to seek a second opinion, especially in case surgery has been decided on as the way forward.