Glaucoma
What is Glaucoma?
Glaucoma is the most common cause of irreversible sight loss in the world. It is most often a result of fluid building up in the front part of the eye. This increases pressure inside the eye damages the optic nerve and can lead to complete and irreversible loss of vision if not properly diagnosed and treated.
What are the symptoms of Glaucoma?
Glaucoma does not usually cause any symptoms to begin with. It tends to develop slowly over many years and initially affects the edges of your vision (peripheral vision).
Because of this, many people may not realise they have glaucoma, and it is frequently only picked up during a routine eye test by an optician. The first symptoms that patients may notice can include blurred vision or seeing rainbow-coloured circles around bright lights. Both eyes are usually affected, although it may be more severe in one eye.
What treatments are available?
There are many treatment options, with more becoming commercially available in recent times. Common treatments available include eye drops as well as laser and surgical options.
Eye Drops
Eye drops are a common and relatively non-invasive treatment for Glaucoma. This course of treatment may be pursued on its own or in tandem with laser or traditional surgical procedures.
There are several different types of eye drops prescribed for the treatment of Glaucoma. All eye drop treatments for Glaucoma work to reduce pressure on the eye, usually by reducing production of fluid in the eye, or by improving the flow of fluid out of the eye. These treatments may include:
- Alpha agonists (such as apraclonidine and brimonidine)
- Beta blockers (such as betaxolol, carteolol, levobunolol and timolol)
- Carbonic anhydrase inhibitors (such as brinzolamide and dorzolamide)
- Cholinergic agonist (such as pilocarpine)
- Prostaglandin/prostamide analogues (such as bimatoprost, latanoprost, tafluprost and travoprost)
The Latest Surgical Techniques (Minimally Invasive Glaucoma Surgery- MIGS) including Laser surgeries
Mr Ahmed is able to provide the latest surgeries available that can be performed as stand procedures or combined with cataract surgery.
Laser procedures include:
- Selective Laser Trabeculoplasty (SLT)
This is an out patient procedure that works best in newly diagnosed glaucoma patients, reducing their need for glaucoma drops and is one of the safest procedures available
- Micropulse Diode Laser Trabeculoplasty (MDLT)
This is the latest non-invasive surgical laser available to help reduce eye pressures in patients with the laser probe being applied to the outside of the eye. It can be used for many different types of glaucoma and can be combined with cataract surgery.
- Endo-Cyclo Photo-coagulation (ECP )
This is a well established laser that reduces the production of fluid in the eye and is normally performed in combination with cataract surgery.
- Innovative cutting edge surgery
- Trabecular bypass surgery including iStent
The iStent is the smallest implantable device used in the human body. This particular stent is made of titanium and is 0.3mm in diameter. The device is normally implanted at the time of cataract surgery to reduce the need for glaucoma drops.
Traditional surgical procedures include:
- Trabeculectomy
Both laser and traditional surgical options for the treatment of Glaucoma involve some variation of a Trabeculoplasty: a surgical technique in which an incision is made to create a scleral flap, which in turn creates a new route for drainage of intra-ocular fluid. The purpose of this is to increase the drainage of fluid from the eye, and thus decrease the pressure on the eye. This procedure is usually successful at lowering eye pressure but does involve a longer recovery period than non-invasive or micro-invasive procedures.
In this procedure, the fluid inside the eye (known as aqueous humour or intra-ocular fluid), drains through the trap-door-like effect produced by the creation of a scleral flap to a small reservoir or bleb just under the eye surface. This is obscured by the eyelid.
The scleral flap is then sutured in such a way as to prevent fluid from draining too quickly. This reduction of fluid (and therefore pressure) within the eye prevents or slows further damage and further loss of vision to glaucoma. However, even a successful reduction of pressure on the eye through a trabeculectomy will not restore vision already lost as a result of glaucoma.
This procedure is usually successful at lowering eye pressure but does involve a longer recovery period than non-invasive or micro-invasive procedures.
- Glaucoma Tube Surgery
Patients who have a history of complex primary and secondary glaucoma and had previous surgery may require re-plumbing of the eye with a silicone tube to allow better drainage of the fluid in the eye and thus lower eye pressure.