How high is your risk for glaucoma?
Your risk is higher if you:
• are older than 40
• have family members with glaucoma
• are of African or Hispanic descent
• have high eye pressure
• are far-sighted or near-sighted
• had a previous eye injury
• have corneas that are thin in the center
• have thinning of the optic nerve
• have diabetes, migraines, poor blood circulation or other health problems affecting the whole body
If you have more than one of these risk factors you have an even higher risk of glaucoma.
Damage due to glaucoma cannot be reversed. It is permanent. Further damage can however be prevented with medicine and surgery.
Treatment options include medication, laser surgery and hospital surgery.
Glaucoma is usually controlled with eye drops. The eye drops lower eye pressure. They either reduce aqueous fluid production or improve drainage at the drainage angle. The aim is to prevent further vision loss. All medications can have side effects. Some drugs can cause problems when combined with other medications. Tell your doctor about all the medicine you take regularly.
Glaucoma drops have side effects that include:
• burning or itching of the eye
• red eyes or redness of skin around the eyes
• blurred vision
• eyelash growth
• changes in your eye color, the skin around your eyes or eyelid appearance.
• change in your pulse and heartbeat
• change in your energy level
• change in breathing (more so if you already have asthma or breathing problems)
• dry mouth
Never change or stop taking your glaucoma medications without talking to your ophthalmologist. Make sure that you do not run out of your medication.
There are two main types of laser surgery to treat glaucoma. Laser surgery is done in the ophthalmologist’s office on an outpatient basis.
• Selective laser trabeculoplasty is done for people who have open-angle glaucoma. A laser is used to make the drainage angle work better. Fluid flows out properly and eye pressure is reduced.
• Iridotomy. This is for people who have angle-closure glaucoma. A laser is used to create a tiny hole in the iris. The hole helps fluid flow to the drainage angle.
Glaucoma surgery in hospital creates a new drainage channel for the aqueous to leave the eye.
- Trabeculectomy. This is where your eye surgeon creates a tiny flap in the sclera (white part of your eye). A bubble (like a pocket) is also formed in the conjunctiva called a filtration bleb. It is usually hidden under the upper eyelid and cannot be seen. Aqueous humor will be able to drain out of the eye through the flap and into the bleb. In the bleb, the fluid is absorbed by tissue around your eye, lowering eye pressure.
- Glaucoma drainage devices. Your ophthalmologist may implant a tiny drainage tube in your eye. It sends the fluid to a collection area. Your eye surgeon creates collection area (reservoir) beneath the conjunctiva that covers the white part of your eye. The fluid is absorbed into nearby blood vessels.
- Minimally-invasive glaucoma surgery (MIGS) can be done at the time of cataract surgery for patients with mild to moderate open angle glaucoma. It requires no additional incisions other than those needed for cataract surgery itself. The device creates a bypass through the blockage site. Patient recovery time is usually rapid. Clinical studies show that most patients experience a reduction in IOP and a reduction in reliance on glaucoma medication.
Your role in glaucoma treatment
Treating glaucoma successfully is a team effort between you and your doctor. Your ophthalmologist will prescribe your glaucoma treatment. It is up to you to follow your doctor’s instructions and use your eye drops.
Once you are taking medications for glaucoma, your ophthalmologist will want to see you regularly. You can expect to visit your ophthalmologist about every 3-6 months. Once diagnosed make sure that you are registered for glaucoma, a PMB condition, at your medical aid. Glaucoma is a Prescribed Minimum Benefit (PMB) disease and once registered these visits are at least partially paid for from your PMB benefit and not from your day-to-day benefit. If you have any.