Close up of eye demonstrating glaucoma


Glaucoma is a group of eye conditions in which the optic nerve becomes damaged, usually due to a rise in intra-ocular pressure (IOP).

If left untreated, this damage (neuropathy) can cause loss of field of vision – and ultimately blindness.

Types of glaucoma

Congenital glaucoma

A rare but serious developmental abnormality of the eye causing glaucoma.

Secondary glaucoma

There are several possible causes including inflammation, trauma, surgery and syndromes such as pigment dispersion and pseudo-exfoliation.These cause raised IOP and glaucoma.

Pigment dispersion syndrome (PDS) is when pigment is released from the iris into the anterior chamber (fluid filled chamber at the front of the eye) which may then lead to a blockage of the drainage canals, a rise in eye pressure and damage to the optic nerve. This is known as pigment dispersion glaucoma.

Pseudo-exfoliation (PXF) is a rare condition caused by a build-up of abnormal protein which may block the outflow of fluid, cause raised eye pressure and may lead to optic nerve damage.

Primary open-angle glaucoma (POAG)

This is the most common form of glaucoma. Ten percent of over 75 year olds will have some form of POAG. The drainage angle of the eye is damaged, preventing the correct amount of fluid from draining away, leading to a raised IOP and damage the optic nerve.

It tends to run in families, with raised intra-ocular pressure the biggest risk factor in POAG. However, glaucoma can occur in patients with “normal” intra-ocular pressure (normal tension glaucoma).

Other risk factors include age, corneal thickness, ethnicity, myopia (shortsightedness) and diabetes.

Primary angle-closure glaucoma (PACG)

This is a much rarer condition in the UK, which occurs when the drainage angle between the iris and cornea, through which fluid passes is unusually narrow and can becomes close off. When this occurs, the inner eye pressure rises sharply, causing pain, nausea, blurred vision and redness in the eye.

It also tends to run in families, with hyperopic (long-sighted) eyes more at risk.

Women are three times more likely to suffer from closed angle attacks.

Symptoms of glaucoma

It is estimated that over 11.2 million people across the world will be completely blind by 2020, as a result of glaucoma.

So understanding the symptoms has never been more important for your eye health.

Symptoms of open-angle glaucoma

There are generally no symptoms or early signs of open-angle glaucoma which is why it is known as the “silent thief of sight”.

If untreated, open-angle glaucoma can lead to sight loss so it is critical to see an eye doctor for regular examinations. If this is in one eye only, it may go unnoticed until vision is profoundly affected.

This is the most common type of glaucoma, and if you are diabetic or have cardiovascular disease you are at an increased risk of developing the eye disease.

The risk of developing open-angle glaucoma also increases with age. If you have a family history of glaucoma and are over the age of 40, you should see an eye doctor every one to two years to monitor your eye health.

Symptoms of angle-closure glaucoma

Symptoms to look out for in angle-closure glaucoma include eye and head pain, the appearance of rainbow colour circles in bright lights, and blurry vision. The pain can cause nausea and vomiting and can even lead to sudden sight loss.

These symptoms can develop quickly and are immediately noticeable. If untreated, you are at risk of suffering from repeated closed angle attacks and/or a sustained raised intraocular pressure (IOP). This can lead to damage to the optic nerve, known as primary angle-closure glaucoma (PACG).

It is crucial that you monitor the condition of your eyes by having regular eye examinations.

Treatment for glaucoma

Every patient is unique, so we offer a detailed consultation with one of our Consultant Ophthalmic Surgeons to determine suitability, answer all your questions and explain the treatment options.

Treatment for POAG is normally with drops but may require laser or surgical procedures. PACG may require laser treatment, surgery and/or medical treatment. Laser treatment would be with peripheral iridotomies (small holes in the iris) in the first instance.

Selective Laser Trabeculoplasty (SLT): uses a laser to promote drainage. It can be used when the glaucoma is first diagnosed instead of drops, or to compliment drop therapy.

MLT Micropulsed Diode Laser Trabeculoplasty: the same risk, effectiveness and repeatability profile as SLT but uses a different laser wavelength. MLT uses a laser which switches on and off many times per “shot” and hence proclaims to cause less inflammation and improve safety. The benefit is yet to be research proven but results are very similar to SLT.  This treatment is available at Optegra Eye Hospital Surrey.

iStent: a microsurgical procedure where a micro trabecular bypass implant helps to drain fluid from the eye and therefore reduces eye pressure. It can be used in combination with cataract surgery.

Trabeculectomy: an operation to lower the pressure in the eye by creating a new drainage channel in the eye, through which fluid drains out into a space under the outer layer of the eye (conjunctiva). This filtering area is called a bleb.

Monitoring service: a twelve month monitoring service to identify and capture any potential glaucoma problems is available at Optegra Eye Hospital North London, Optegra Eye Hospital Manchester and Optegra Eye Hospital Hampshire.

Optegra Eye Hospital

Our Hospitals and Consultants

All treatments are carried out in our own dedicated Eye Hospitals. You will be cared for in relaxing and comfortable surroundings. Your consultation is provided by the same renowned Consultant Ophthalmic Surgeon who will deliver your treatment.

Optegra delivers a full range of techniques and procedures using the very latest technology. We provide laser eye surgery, permanent lens replacement surgery, cataract surgery and treatment for other medical eye conditions including glaucoma.

What does the Glaucoma Monitoring Service involve?

We offer a bespoke monitoring service for glaucoma patients at Optegra Eye Hospital North London and Optegra Eye Hospital Manchester.

Our Glaucoma Monitoring Service identifies and captures any potential risks or developments over a period of twelve months. It is suitable for anyone who has, or is at risk of developing glaucoma, and is concerned about its potential progression. The service offers continued care and support to give peace of mind during what can be a daunting time.

Patients are assessed by an Optometrist and a Consultant Ophthalmic Surgeon through a series of thorough and comprehensive tests. The service uses state-of-the-art imaging equipment including the Heidelberg Spectralis OCT.

At the end of the twelve months, the patient receives a final review and is given the opportunity to continue with the monitoring service.


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