Glaucoma. The silent thief of sight.

13 March 2017

Glaucoma is a significant cause of blindness and low vision in people over the age of 40.

Often, by the time a person is diagnosed with glaucoma, irreversible damage may have been done to their vision. This is because they may not experience any symptoms, pain or changes to their sight in the early stages of glaucoma.

While there is no cure for glaucoma, people can reduce the risk of permanent vision loss by attending regular check-ups and maintaining treatment programs.

And, the more people understand the condition, the better they can adapt to living a full life with their remaining vision.

Glaucoma explained

Glaucoma is a group of eye diseases that cause progressive damage to the optic nerve, which carries vision information from the eye to the brain.

The front part of the eye is nourished by a fluid called the aqueous, which is constantly produced and drained away inside the eye. This process maintains the intraocular pressure – the pressure in the eye – within a healthy range.

The most common type of glaucoma is open-angle glaucoma, which occurs when the aqueous does not drain correctly. As a result of this impaired drainage the pressure inside the eye builds up gradually and causes damage to the optic nerve.

There are other types of glaucoma in which the damage to the optic nerve is more rapid, but these are much less common and are often associated with other eye disorders.

Who is affected by glaucoma

People of all ages, including babies, children and young adults can be diagnosed with glaucoma.  Generally, one in 200 people in their 40s have glaucoma and the incidence rises with a person’s age, rising to one in eight people in their 80s.

Currently, around 300,000 Australians are affected by glaucoma and this number is expected to grow to around 400,000 people by 2025 because of our ageing population. 

How it affects your vision

The first thing a person might notice is a slight loss of their side or peripheral vision.

As the disease develops, the loss of peripheral vision worsens and they may have difficulty seeing in environments with low light and become more sensitive to glare. If there is significant loss of peripheral vision, activities such as driving may no longer be safe.

The following image gives an impression of what someone with glaucoma may see compared to someone with regular vision. 

Simulation image of how glaucoma affects vision.

Diagnosis of glaucoma

Glaucoma is picked up through eye checks with an eye specialist.

If you already wear glasses, your optometrist will conduct a pressure test and take a photo of your optic nerve to check for glaucoma, as part of your regular eye test. If you are seeing an ophthalmologist, they will also test for glaucoma.

If however you don’t regularly have your eyes checked, and you have one of the following risk factors, you should see an eye specialist as early detection can usually save your sight:

  • family history of glaucoma
  • aged over 40
  • diabetic
  • have hypertension
  • have had a serious eye injury
  • used steroid treatment over a long period of time

Treatment of glaucoma

Many people with glaucoma ask if they will go blind.

The answer depends on a number of factors including how early the glaucoma is diagnosed and how well treatment and maintenance programs are followed.

There are a number of treatments that can help to control the glaucoma and these may slow the deterioration of a person’s sight.

These include eye drops, laser, and surgery. A combination of these treatments may be used but they all have the same aim: reducing the pressure in the eye in order to avoid further damage to the optic nerve.

Managing glaucoma

There are a number of things you can to do to manage your glaucoma.

Make sure you take your eye drops or medications as recommended by your eye specialist. A bottle squeezer may be provided with the eye drops or you can buy one from a chemist or online to help with this task.

Glaucoma drops do not improve the vision which has already been lost but they are vital in reducing the pressure in the eye in order to prevent progression of the disease. If you have problems with using the prescribed eye drops, discuss this with your specialist because there may be alternative medications.

Most importantly, don’t forget to attend your regular check-ups with your eye specialist. This is even more critical if you have another eye condition such as age-related macular degeneration.

During these check-ups the eye specialist will assess your eyes. They will conduct a pressure test, and may take photos of your optic nerve and test your field of vision to check on glaucoma damage.

These check-ups will help you and your eye specialist understand how your glaucoma is progressing so you can both develop any new management strategies.

Everyday living with glaucoma

Having glaucoma can make some everyday tasks like reading and going out in low-lit places challenging. But with the right supports you can continue enjoying these activities.

The most common supports we provide to people with glaucoma are:

  1. Personalised lighting assessments to determine how to use lighting for reading or other tasks.
  2. Magnifying equipment can also help with activities that involve fine detail, such as reading. A hand-held magnifier can also be very useful in low-light environments such as a restaurant.
  3. As glaucoma reduces a person’s peripheral vision, they may require support to learn new ways of navigating inside and outside the home, including at work.
  4. Adaptive technology such as talking watches, screen reading software and other adaptive technology to continue enjoying everyday activities, staying in touch with family and friends, and being supported in the workplace.

Other factors to consider

Because glaucoma is passed down in families, it’s essential that you tell your family that you have been diagnosed so they can get checked too. Remember, early detection can protect against vision loss.