Focus on Glaucoma

What is Glaucoma?

Glaucoma is a group of eye diseases that can damage the optic nerve and cause vision loss, typically in both eyes.

Symptoms of glaucoma may include a gradual loss of peripheral vision, halos around lights, and eye pain. Glaucoma is often referred to as the "silent thief of sight" because it usually has no symptoms in the early stages. It is usually identified during routine eye tests, which is why it's so important to keep up with your regular optician, optometrist or ophthalmologist appointments.

The different types of glaucoma

Primary Glaucoma

These are the most common types of glaucoma and are known as Primary Open-Angle Glaucoma (POAG) and Primary Angle-Closure Glaucoma (PACG)

The most common type of glaucoma is Primary Open-Angle Glaucoma (POAG). It's caused by increased pressure within the eye (known as intraocular pressure). This pressure can damage the optic nerve which transmits visual information from the eye to the brain.

Primary angle-closure glaucoma (PACG) is less common. This type of glaucoma is more closely related to the shape of the eye and how it sits in the eye socket. Again, this can lead to an increase in pressure in the eye, which damages the optic nerve and presses on the nerve itself.

Secondary Glaucoma

This term describes glaucoma that happens as a side effect of medical trauma or underlying medical condition. It relates to a build-up of fluid in the eye, which causes an increase in eye pressure and damages the optic nerve.

Developmental Glaucoma

Also known as 'childhood glaucoma' or 'infantile glaucoma'. These are rare and only affect around five in 100,000 children.

Developmental glaucoma usually occurs when the eye does not develop properly. This leads to a build-up of fluid in the eye, causing a rise of pressure in the eye, which leads to stress or damage to the optic nerve. There is also secondary glaucoma that can occur due to other medical or developmental conditions, or eye trauma.

What Glaucoma might look like

Please note this is a simulation of glaucoma, based on the anecdotal experiences of people who have the condition.
This image is not the experience of everyone with glaucoma and is for illustration purposes only.

Symptoms of Glaucoma

The symptoms of glaucoma can vary depending on the type of glaucoma and the stage of the disease. There may be no symptoms in the early stages of glaucoma.

Symptoms of open-angle glaucoma may include:

Gradual loss of peripheral vision. You may not notice anything wrong until significant vision loss has occurred
Halos around lights
Eye pain

Symptoms of angle-closure glaucoma may include:

Sudden onset of eye pain
Nausea and vomiting
Blurred vision
Seeing rainbow-coloured circles around lights
Redness in the eye

It's important to note that these symptoms are not specific to glaucoma; other conditions can cause them, so a proper diagnosis from a medical professional is essential.

"Glaucoma is the leading cause of irreversible blindness in the world"

World Health Organisation

Diagnosis

There are several tests your optometrist or ophthalmologist might use to diagnose glaucoma. It's important to note that no one test can confirm the diagnosis of glaucoma, so optometrists and ophthalmologists may use a combination of these tests to make a diagnosis.

Tonometry

Tonometry is a test that measures the pressure inside the eye (intraocular pressure). This is one of the most important tests for diagnosing glaucoma, as increased intraocular pressure is a significant risk factor for the disease.

Visual Field Test

This test measures the patient's peripheral vision, which can be affected by glaucoma. The patient sits in front of a machine and presses a button when they see a light flash in different parts of their visual field.

Pachymetry

This test measures the thickness of the cornea, which can help determine the level of intraocular pressure.

Ophthalmoscopy

This test allows the optometrist or ophthalmologist to examine the retina and optic nerve for signs of damage.

Imaging

Imaging tests, like Optical Coherence Tomography (OCT), can provide detailed images of the retina and optic nerve, which can be helpful in detecting early signs of glaucoma.

Gonioscopy

This test allows the optometrist or ophthalmologist to examine the angle of the eye, where the iris meets the cornea. It can help identify if the patient has angle-closure glaucoma.

With an ageing population and modern technology making earlier detection possible, the number of people living with glaucoma worldwide is expected to increase to over 111 million by 2040.

Glaucoma UK / BrightFocus Foundation

Treatment

There are several treatment options available for glaucoma:

Medications

Eye drops and oral medications can be used to lower intraocular pressure and slow the progression of the disease. These medications work by either decreasing the amount of fluid produced by the eye or increasing the amount of fluid that drains out of the eye.

Laser surgery

This type of surgery uses a laser to create a new opening for fluid to drain out of the eye, which can help lower intraocular pressure.

Traditional surgery

This type of surgery, called trabeculectomy, involves creating a new opening for fluid to drain out of the eye by removing a small piece of the eye's drainage system.

Micro-invasive glaucoma surgery (MIGS)

This is a newer type of surgery that is less invasive, and it's done through a small incision; it helps lower the intraocular pressure by increasing the outflow of the aqueous humour or reducing its production.

It's important to note that the type of treatment chosen will depend on the type and stage of glaucoma and the individual patient's preferences and medical history. In some cases, more than one type of treatment may be used. Regular follow-up appointments with an ophthalmologist are also essential to monitor the condition and adjust the treatment if necessary.

Living with Glaucoma

Living with glaucoma can be challenging, but there are several things you can do to manage the disease and maintain your vision:

Take medication as prescribed

It's important to take your medicines as directed by your doctor, optometrist or ophthalmologist, and to inform them of any side effects or changes in your condition.

Schedule regular eye exams

Regular eye exams are essential for monitoring the progression of the disease and adjusting treatment as needed.

Make lifestyle changes

Some lifestyle changes that can help reduce your risk of developing glaucoma include eating a healthy diet, maintaining a healthy weight, and avoiding smoking.

Use assistive technology

There's lots of technology available to help you with everyday tasks, staying in touch with loved ones and accessing entertainment. Whatever your experience is with computers, Dolphin assistive technology can help. Assistive tech from Dolphin includes screen magnifiers, screen readers and accessible book readers.

Access support

Vision loss can be difficult to accept but learning to live with a chronic condition like glaucoma is possible. Joining a support group or working with a counsellor can help you cope with the emotional aspects of the disease.

It's important to work closely with your healthcare provider to manage your glaucoma, following their advice and making lifestyle changes that can help to slow the progression of the disease and maintain your vision.

About Glaucoma

Glaucoma is a group of eye diseases that damage the optic nerve, which connects the eye to the brain. The damage is caused by increased intraocular pressure (IOP), which can cause the nerve fibres in the eye to die gradually. This can lead to vision loss, including blindness.

There are two main types of glaucoma: open-angle and angle-closure. Open-angle glaucoma is the most common form, accounting for around 90% of all cases. It occurs when the angle between the iris and the cornea is open, but the eye drainage canals become clogged, leading to an increase in IOP. Angle-closure glaucoma is less common, but it can be more severe. It occurs when the angle between the iris and the cornea is closed, which can block fluid flow out of the eye, leading to a rapid increase in IOP.

"Glaucoma is often symptomless and the only way to find out whether you have it is to have your eyes checked."

Glaucoma UK

Glaucoma risk factors include age, family history, African-American or Hispanic descent, high IOP, and certain medical conditions such as diabetes or hypertension. People with these risk factors should have regular eye exams to check for glaucoma.

Symptoms of open-angle glaucoma can include gradually worsening peripheral vision with no pain or redness. In contrast, angle-closure glaucoma can cause sudden eye pain, redness, nausea, and blurred vision. These symptoms require immediate medical attention.

Diagnosis of glaucoma is typically made by an ophthalmologist, a medical doctor specialising in eye care. The doctor will perform a comprehensive eye exam, including measuring IOP, inspecting the drainage angle, and evaluating the optic nerve.

Treatment of glaucoma typically includes eye drops to lower IOP. These can consist of prostaglandin analogues, beta-blockers, and carbonic anhydrase inhibitors. In some cases, laser surgery or traditional surgery may be necessary to help lower IOP. It's important to note that there is no cure for glaucoma, so treatment is focused on slowing or preventing further vision loss.

One of the most important things people with glaucoma can do to protect their vision is to take eye drops as prescribed by their doctor. They should also have regular eye exams to monitor the progression of the disease and make any necessary adjustments to their treatment plan.

"Millions of people in the UK are entitled to a free NHS sight test, and you might be eligible without knowing it."

Glaucoma UK

It's important to diagnose and treat glaucoma as early as possible, as vision loss from glaucoma is irreversible. In addition, early detection and treatment can help slow or prevent further vision loss, allowing people to maintain their quality of life.

What is Assistive Technology?

If you are blind or partially sighted, Dolphin assistive technology helps you maintain independence. We develop this specialist software specifically for people who are experiencing sight loss. Dolphin software includes screen magnification and screen reading technology. It helps you work or study, access the internet and read all the information on a computer screen, so you can complete everyday tasks independently.

Dolphin assistive technology makes a difference and helps you to maintain your independence, whether you use it at home, at work or to study.

About GuideConnect

Whether you are an experienced computer user or a complete beginner, GuideConnect is easy-to-use computer technology, designed for people with visual impairments. It can be used through your own TV, on a tablet or computer. With high-contrast icons, talking menus and adjustable text sizes to help guide you through many different tasks.

GuideConnect helps people who are losing their sight stay independent for longer. It connects you to friends and family, enables you to do everyday tasks like reading your post and provides access to a range of entertainment such as audiobooks, games and radio.

Find out more about Dolphin Computer Access

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If you would like to find out more about the technology available for people who are blind or partially sighted, or how Dolphin technology can help people with neurodiversities including dyslexia, sign up for Dolphin newsletters.

We usually send out an email each month, with up to date information on accessibility and how Dolphin assistive tech helps people in different situations - including education, work and at home. These emails also highlight the events we attend each month, and the webinars which can help you find out more about Dolphin assistive tech.