Glaucoma Treatment Perth

What is Glaucoma

Glaucoma is the name given to a group of eye disorders that contribute to the build up of pressure inside your eyeball. The increased pressure inside the eyeball, in some cases, can cause damage to the optic nerve, resulting in the loss of vision.

Help centre – What is the Optic nerve?

Optic nerve – Your optic nerve basically connects your eye to your brain. It carries the impulses formed by the retina (the nerve layer that lines the back of the eye) that senses light and creates impulses. These impulses are sent via the optic nerve to the brain, which then interprets them as images.

Definition from Glaucoma Australia.

What causes Glaucoma

Glaucoma usually occurs when fluid builds up in the front part of your eye.

That extra fluid increases the pressure in the eye, eventually damaging the optic nerve.

The fluid (called aqueous fluid which bathes and nourishes the eye) build up is commonly caused by a blockage or reduced efficiency in the eye’s aqueous drainage system.

The fluid can’t exit the eye, which results in pressure build up within the eye.

The increased pressure damages the optic nerve and eventually leads to progressive vision loss, and if not treated, blindness.

Glaucoma facts:

• Approximately 300,000 Australians have glaucoma.
• Currently, about 50% of people with glaucoma remain undetected.
• Blindness from glaucoma can often be prevented with early treatment.

Facts from Glaucoma Australia

Two types of Glaucoma

1. Primary open-angle glaucoma

This type of glaucoma happens gradually and is generally painless. It is the most common type of glaucoma.

As described above the aqueous fluid does not drain effectively from the eye, and as a result pressure builds up in the eye, which damages the optic nerve overtime, leading to progressive vision loss.

2. Angle-closure glaucom

Also called “closed-angle glaucoma” or “narrow-angle glaucoma” occurs when the iris is very close to the drainage angle in the eye. The iris can end up blocking the drainage angle. If completely blocked, eye pressure rises very quickly.

You may exhibit the following signs from angle-closure glaucoma attack – You/your:

• • Vision is suddenly blurry
  • Have severe eye pain
  • Have a headache
  • Feel sick to your stomach (nausea)
  • Throw up/vomit
  • See rainbow-colored rings or halos around lights

There are two ways you may develop angle-closure glaucoma:

1. 1. Acute attack – As described above. Seek emergency care immediately.
   2. Develop it slowly – This is called chronic angle-closure glaucoma. There are no symptoms at first, so you don’t know you have it until the damage is severe or experience attack symptoms described above.

Angle-closure glaucoma can cause blindness if not treated immediately.

Glaucoma treatments

Glaucoma damage is permanent and cannot be reversed, though medicine and surgery may help to prevent further damage. To treat glaucoma, your ophthalmologist may use one or more of the following treatments:

1. Medication

Medication treatment may include eye drops and/or tablets. Used every day, the eye drops or tablets may help lower eye pressure by reducing the amount of aqueous fluid the eye makes or by helping fluid flow better through the drainage angle.

Some medications may have side effects such as:

• • Red and/or itchy eyes
  • Blurred vision
  • Eye colour or eye lid discolouration

Discuss these options with your Ophthalmologist from WA Eye Specialists.

2. Laser treatment

There are two main types of laser treatment to drain aqueous fluid from the eye or to relieve angle blockage.

Selective Laser Trabeculoplasty (SLT) – This treatment is for people who have open-angle glaucoma. The eye surgeon uses a laser to make the drainage angle work better to allow fluid to flow out more efficiently and eye pressure is reduced.

YAG Laser Iridotomy – This is for people who have angle-closure glaucoma. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle reducing the pressure in the eye

There are three main operations used to create a new drainage channel for the aqueous fluid to leave the eye to reduce pressure:

Trabeculectomy –  Your eye surgeon creates a tiny flap in the sclera (white of your eye) and also creates a pocket in the conjunctiva called a filtration bleb. It is usually hidden under the upper eyelid and cannot be seen.

Aqueous fluid will be able to drain out of the eye through the flap and into the bleb where the fluid is absorbed by tissue around your eye, lowering eye pressure.

Glaucoma drainage devices – A tiny drainage tube is implanted in your eye to send the fluid to a collection area called a reservoir. The fluid is then absorbed into nearby blood vessels reducing the pressure in the eye.

Minimally invasive glaucoma surgery (MIGS) – MIGS is used for less advanced but medically resistant glaucoma. MIGS uses microscopic equipment with smaller incision to reduce intraocular pressure such as iStents, Canaliculoplasty and Xen Implant

Treatment approach

Determining which treatment may be the best for you is dependant on the type of glaucoma and stage of the disease. You doctor will discuss all the details of each treatment with you to help you make the decision on which approach may best suite your circumstances based on your risk factors, clinical findings and test results.

Important notes on glaucoma

Eye pressure – Eye pressure may vary from person to person; what is high pressure for one person may not be for another. Many people may have normal pressure inside the eye and still have glaucoma.

Glaucoma Treatment Perth

Our specialist ophthalmologists see patients from all over Western Australia. They have extensive experience in the diagnosis and treatment of a wide range of eye conditions including Glaucoma. WA Eye Specialists have four practices located in Perth in Armadale, Joondalup, Midland, Murdoch and South Perth.