Glaucoma
Found early, glaucoma is a manageable long-term condition.
Overview
Glaucoma damages the optic nerve slowly and without pain, beginning at the edges of vision, where the brain compensates so effectively that nothing seems wrong. By the time most people notice a change, a considerable amount of nerve has already been lost, and that loss is permanent.
This is why finding it early matters more here than almost anywhere else in eye care. Detected in time, glaucoma becomes a manageable long-term condition: pressure is lowered to a target set for your eye, and the nerve is monitored with scans sensitive enough to see change long before you could.
When to seek assessment
- Usually none at all until the condition is advanced
- A gradual loss of awareness at the edges of vision
- Difficulty adjusting when the lighting changes
- Sudden severe pain, redness, haloes and nausea — this is an emergency
- A parent or sibling with glaucoma, which raises your own risk several times over
Diagnosis
How the assessment is made
Eye pressure, measured properly
Pressure readings corrected for the thickness of your cornea, because a thin cornea gives a falsely low reading and can hide real risk.
Optic nerve scan
A scan that measures the nerve fibre layer in microns and can detect loss several years before any change appears on a visual field test.
Visual field test
A map of your side vision, repeated over time so that genuine change can be told apart from the normal variation of the test.
Examining the drainage angle
A direct look at where fluid leaves the eye, which distinguishes the two main forms of glaucoma — they need quite different treatment.
Treatment
Options and what each one is for
Drops
Pressure-lowering drops adjusted until your individual target is reached, with preservative-free options where the surface of the eye is sensitive.
Laser treatment (SLT)
A painless outpatient laser that helps the eye drain naturally, increasingly used as a first treatment instead of daily drops.
Protective laser for narrow angles
A tiny opening made in the iris to prevent a sudden, painful rise in pressure in eyes with a narrow drainage angle.
Surgery when it is needed
Modern minimally invasive procedures and, in advanced disease, drainage surgery — reserved for eyes that have not reached target on medical treatment.
Recovery
What to expect afterwards
After laser
A few hours of mild blurring and light sensitivity. Normal activity the same day, with a pressure check within a fortnight.
After surgery
Frequent review over the first six weeks while drops are adjusted. Vision fluctuates before settling.
Lifelong
Review every three to six months with periodic scans. Using the treatment consistently is the strongest single predictor of keeping your sight.
Questions
Frequently asked
If your question is not answered here, it is welcome in consultation — or by message before you book.
It cannot, which is precisely why treatment is aimed at protecting the vision that remains. Finding it early is the one real advantage available in this condition.