Glaucoma
Glaucoma is a condition where there is damage to the optic nerve. This nerve sits at the back of your eye and transports the images your eyes see to your brain for processing. Glaucoma can threaten your vision, either by direct damage to the optic nerve, or by an increase in pressure in the fluid filling the eye, and thereby squeezing the optic nerve. It can ultimately lead to a loss of vision, so it's important it's detected and treated early.
There are two usual types of glaucoma, based on whether pressure increases slowly or quickly. Chronic open-angle glaucoma - the most common type - is where pressure inside the eye builds slowly, so the loss of vision occurs gradually. You might not even notice changes early on, but you're most likely to lose vision in the outer edges of your vision (the periphery) first. It's often picked up on a routine check-up with your optician, where they check eye pressure by blowing a puff of air on your eyeball. This type of glaucoma usually affects both eyes and is painless. Among white Europeans, about 1 in 50 people over 40 years of age and 1 in 10 people over 75 years of age have chronic open-angle glaucoma.
Acute angle glaucoma is much less common. Pressure builds rapidly inside the eye and threatens vision if not treated urgently. You might feel severe pain in or around your eye or in the head, the eye may feel tight or full, lights may appear to have halos around them and you might complain of blurred vision. You may even feel unwell and be vomiting. This is an emergency and you should seek medical attention urgently.
Other possible types of glaucoma include secondary glaucoma – caused by an eye injury or inflammation of the middle layer of the eye – and congenital glaucoma which is rare but present at birth.
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Who's at risk of getting glaucoma?
The risk increases with age, and it's most common in people aged over 60. It's also more common in people who are of Asian, Afro-Caribbean or African ethnicity, people who are short or long-sighted, have diabetes or have a family history of glaucoma. If you are in any of these high-risk groups, make sure you get your eyes checked every year once you are aged over 40 or get your eyes checked if you notice any vision changes. It's hard to reverse damage to vision once it has set in but treatment can prevent further vision loss. In the UK about 2% of the population over the age of 40 have glaucoma, and it is one of the leading causes of blindness in the world If you have suffered from any form of glaucoma it is important to let your family members know as they may be at increased risk of developing it, so they should get regular eye checks.
When should I see my doctor?
You should discuss any of these risk factors with your optician and arrange regular eye checks. You should see your optician or doctor as soon as possible if you have any vision changes. It's hard to reverse damage to vision once it has set in but treatment can prevent further vision loss. They will also check for cataracts.
If you have any of the above symptoms of acute angle glaucoma it's important to seek urgent medical attention via an urgent visit with your doctor, or by calling 111 or going to eye casualty. Avoid lying down or being in a dark room as this can make it worse.
Am I fit for work?
Your doctor will discuss with you whether you will need any adaptation to work depending on your symptoms or any visual loss resulting from glaucoma. If you have acute angle glaucoma you are not fit for work as you need urgent treatment.
What will the doctor do
The doctor or optician will ask you about your medical history, about any family history of vision problems in your family who has suffered from glaucoma and ask about your current symptoms. They will examine your eyes, test your vision and - if at the optician's or eye casualty department - they will measure the eye pressure. The pressure is checked using a small handheld device that sends a puff of air into your eye - it is not painful but may make you jump!
If glaucoma is diagnosed, you will be given eye drops that will help lower the pressure inside your eye. You may be referred to a specialist eye clinic and there are options of laser treatment or surgery in certain cases of glaucoma, particularly acute angle glaucoma.
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