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Auckland DHB Ophthalmology Services

Public Service, Ophthalmology

Glaucoma

Glaucoma is a group of diseases that can damage the eye’s optic nerve and may result in vision loss and blindness. Multiple factors are often important in causing glaucoma, but it is most commonly related to in an increase in pressure in the eye. The chronic form of glaucoma is known as the silent thief of vision as symptoms are generally absent until the condition has progressed to an advanced stage. 

Very occasionally, a rarer form of glaucoma can develop suddenly and symptoms may then include: headaches and aches around the affected eye, seeing halos around lights, sensitivity to light, blurred vision, nausea and vomiting.

You may be more likely to develop glaucoma if you:

  • have someone else in your family with glaucoma
  • already have high pressure in your eye
  • have experienced injury to your eye
  • have had other eye conditions that can cause the eye pressure to rise
  • have migraine or circulation problems.

Glaucoma is more common in people over 50 years of age and more common in women than men. Diagnosis usually comes after consultation with an eye doctor. Signs of glaucoma may also be picked up at an optometrist’s eye examination.

The following tests are used to diagnose and monitor glaucoma:

  • Visual acuity test – test to check distance vision using an eye chart.
  • Tonometry – measures eye pressure.  It is often the first screening test for glaucoma. The eyes are numbed with eye drops and then examined. 
  • Dilated eye exam – this is done using the slit lamp and a lens which allows the clinician to examine the back of the eye.  The optic nerve in particular is examined for any signs of damage.  
  • Visual field test – test to measure side (peripheral) vision. 
  • Pachymetry – test to measure the thickness of the cornea.

Many other new techniques are emerging to help identify the likelihood of glaucoma and help determine its rate of progression.

Eye drops to decrease eye pressure are the most common early treatment. There are many different options of eye drops we can use and sometimes more than one medication is required. 

Surgery may be required, especially if medications are not taking adequate effect. 

One of the more common operations to control glaucoma is a trabeculectomy and is performed when other methods have failed to adequately control eye pressure. This is a medium length operation that makes a new opening for fluid to drain from the eye.

Other options for treatment can also be use such as Laser trabeculoplasty, in which a surgeon uses a laser to help open the drainage channels and allow more fluid to drain from the eye.  Usually after laser treatment eye drops will still be needed although it may reduce the number of drops required.

Although glaucoma cannot be cured, early treatment can prevent further worsening of the condition and vision loss. Regular eye examinations will need to be continued life-long. 

Most people diagnosed with glaucoma will be on treatment for life.  Without treatment the eye pressure will return to the pre-treatment levels and continued damage to the optic nerve can occur.

If you are concerned about whether you have glaucoma or not you should see a community optometrist for an assessment. If necessary a referral can be made to the ophthalmology department.

For more information go to: https://www.glaucoma.org.nz/ 

This page was last updated at 2:45PM on November 4, 2021.