Glaucoma Treatment In Shrewsbury And Surrounding Areas!

What causes Glaucoma?

Let us explain with the simple example of a kitchen sink at your home.

There is a tap through which you can fill the sink, and there is a drain through which water can leave the sink. If the drain is blocked, water accumulates in the sink. Similarly, in your eye, there is an area which produces a clear fluid called the aqueous humour, which circulates inside the eye and provides oxygen and nourishment to the internal structures.

Likewise, there is a small drainage channel through which all the waste products from inside the eye are drained. It is a sieve-like structure called the trabecular meshwork.

In glaucoma, this passage or the drainage channel is blocked, either at its entrance or beyond. Unlike your kitchen sink, the eye is a closed structure, so excess water cannot overflow. This causes pressure in your eye to build up.

This increased pressure causes damage to the optic nerve when it is called glaucoma. If it hasn’t caused damage yet, we call it Ocular Hypertension.

When the block is at the entrance it is called Narrow Angle Glaucoma or Angle Closure Glaucoma. When the blockage is not at the entrance, but beyond, somewhere inside, we call it Open Angle Glaucoma.

Types

Open-Angle Glaucoma

It is the most common form of glaucoma. Due to poor drainage in the iris, the pressure builds up gradually. Open-angle glaucoma is not apparent until peripheral (side) vision is lost through the slow build-up of pressure.

Acute Closed-Angle Glaucoma

Acute closed-angle glaucoma is more sudden and occurs when a blockage occurs in the normal flow of eye fluid between the iris and the lens. It needs to be treated immediately on an emergency basis or the patient could risk losing their eyesight. All the symptoms mentioned above are present prior to any incident occurring.

Congenital Glaucoma

Some babies may be born with defective drainage canals in the eye. This can cause permanent vision damage in the child, if not corrected. Thankfully, most doctors can recognise this early on, leading to timely eye care treatments.

Symptoms

Glaucoma usually does not have noticeable symptoms; hence the name, silent thief of sight. The best glaucoma specialists In Shrewsbury recommend regular eye exams and a glaucoma screening test for early detection and prevention.

Some patients who are at risk of Glaucoma may experience:

• Headaches.
• Blurry Vision with Halos around light.
• Pain and Pressure In Eyes.
• Red and Sore Eyes.
• Nausea and Vomiting.

Causes Of Glaucoma

Your eye produces a clear fluid called the aqueous humour. This fluid circulates oxygen in the eye and then drains through a small drainage channel. The drainage channel is compromised in glaucoma, causing the fluid to build up. This build-up fluid puts pressure on the optic nerve, causing it to deteriorate. 

Here are the risk factors that elevate the chances of glaucoma

• Glaucoma is more common in senior citizens, especially those over the age of 60. 
• Glaucoma can be hereditary. If your parents or family members suffer from it, it is very likely for you to develop it.
• Patients of diabetes and high blood pressure.
• Those who have a long history of steroid use.
• Those who already suffer from severe near-sightedness (Myopia).
• If you have any eye injury.

Risks

Anyone can get glaucoma, but knowing the risk factors for the disease and being screened for it will give you a head start on detecting and treating the disease. Doing so is important because any vision lost in glaucoma patients cannot be regained. Unfortunately, everyone is at risk for developing glaucoma, but certain groups have a higher risk, including:

• All individuals who are over the age of 60
  Glaucoma is much more common among older people. You are six times more likely to get glaucoma if you are over 60 years old.
• Those with a family history of glaucoma 
  The most common type of glaucoma, primary open-angle glaucoma, has a hereditary link. If anyone your immediate family have glaucoma, you are at a much higher risk, about four to nine times, than the rest of the population.
• Diabetics or those with high blood pressure 
• Long term Steroid users
• People with high myopia (severe near-sightedness)
• Afro-carribean race
• Migraines or Raynaud’s Phenomenon
• Oral contraceptive medications
• Sleep apnea
• Previous eye injury
  Blunt injuries, usually sports related injuries with a ball hitting the eye, or injuries that penetrate the eye can damage the eye’s drainage system, leading to raised pressures and traumatic glaucoma.

Diagnosis

Glaucoma is not always detectable; making it difficult to diagnose. However, early detection and treatment are also of the utmost importance for any glaucoma patient. Frequent eye tests using advanced technology like OCT Retinal Nerve Fibre layer Analysis and visual field tests are the best options to detect the condition early. 

Types Of Tests Used In Diagnosis

• Ophthalmoscopy: Ophthalmoscopy examines the optic nerve for any signs of glaucoma damage. Glaucoma monitoring is the way to go forward if any signs are found. The doctor uses eye drops to dilate the pupils and examine the shape and colour of the optic nerve, using a slit lamp.
• Perimetry: Perimetry is used to determine if glaucoma has already affected your field of vision. The test produces a map of your field of vision, which is used to access your peripheral vision. 
• Gonioscopy: It is one of the best tests for glaucoma as it directly measures if the drainage canal is open, narrow, or closed. Abnormalities like pigment in the angle and pseudoexfoliation can also be accessed using this method.
• Pachymetry: Pachymetry measures the thickness of your cornea. Corneal thickness is one of the indicators of abnormal eye pressure. Pachymetry is a painless and simple procedure.
• Retinal Nerve Fibre Layer Analysis with OCT Scan: This is one of the most advanced scanning technologies we offer to all glaucoma patients at Paragon Clinic. This test yields accurate results and is relatively simple.

Investigations

• Ophthalmoscopy:  This diagnostic procedure helps your consultant examine your optic nerve for any signs of glaucoma damage, and if present, to monitor any changes over a period of time. Eye drops may be used to dilate the pupil. Your consultant will then use a small high powered lens when you sit on the slitlamp to examine the shape and colour of the optic nerve and the ratio of the nerve fibres compared to the total size of the optic nerve, the cup:disc ratio, also called the optic disc “cupping”.

• Perimetry: Perimetry is a visual field test that produces a map of your field of vision. This test will help your consultant determine whether your vision has been affected by glaucoma. During this test, you will be asked to look straight ahead as a light spot is repeatedly presented in different areas of your peripheral vision. Damaged areas of the visual field can be identified this way.
  Ideally this test is repeated every 6 months, so that any damage can be picked up early.

• Gonioscopy: This diagnostic test is used to determine whether the angle where the iris meets the cornea, called the irido-corneal angle, or just the angle, is open and wide or narrow and closed. During the exam, eye drops are used to numb the eye. A hand-held contact lens called a gonio lens is gently placed on the eye. This contact lens has a mirror that shows the consultant if the angle between the iris and cornea is closed and blocked (a possible sign of angle-closure or acute glaucoma) or wide and open (a possible sign of open-angle, chronic glaucoma). Also, other abnormalities like pigment in the angle, pseudoexfoliation etc can also be identified that can suggest other causes of glaucoma.

• Pachymetry: Pachymetry is a simple, painless test to measure the thickness of your cornea — the clear window at the front of the eye. A probe called a pachymeter is gently placed on the front of the eye (the cornea) to measure its thickness. Pachymetry can help your diagnosis, because corneal thickness has the potential to influence eye pressure readings. With this measurement, your doctor can better understand your IOP reading and develop a treatment plan that is right for you. The procedure takes only about a minute to measure both eyes.

• Retinal Nerve Fibre Layer Analysis with OCT Scan: This is one of the most advanced scanning technologies we offer to all glaucoma patients at Paragon Clinic. Not only is the test important, proper interpretation of the results by a highly trained glaucoma specialist is necessary to optimise you treatment.

Laser Treatments for Glaucoma

Selective Laser Trabeculoplasty (SLT), simply known as laser treatment is an effective method for improving fluid drainage from your eye. It is a minimally invasive treatment that can be an alternative to eye drops or be used alongside it.

The effects of laser glaucoma treatment can last for years after the initial treatment. The treatment can be repeated as well if you notice any symptoms come back.