Glaucoma

Glaucoma

Glaucoma is a disease of the optic nerve(s), the nerve which transmits the visual information captured by the eye for transport to the brain, so that a person can see. In this condition, the nerve(s) become irreversibly damaged through nerve fibre loss over time, and without appropriate treatment it is relentlessly progressive, which leads to common patterns of loss of the field of vision (and ultimately, central vision). In patients who have glaucoma, the disease may be present in one or both eyes.  While not all cases of glaucoma are associated with a rise in intraocular pressure (the pressure of the inside of the eye), it is a feature of the disease which is seen in most cases. The term glaucoma actually defines a large group of diseases which have the common threads mentioned above. There are three main types of glaucoma, most commonly open-angle glaucoma, followed by closed-angle glaucoma and followed by the most rare, congenital glaucoma. Recommended treatments will vary by the type and subtype of glaucoma, however an emphasis is placed on screening for the beginning of glaucoma, as well as review of progress of glaucoma (if any) in established cases. The more severe the case of glaucoma, the more important the need for shorter follow-up time between appointments, as additional damage to an already damaged optic nerve will result in more rapid visual field and vision loss.

The mainstay of treatment in glaucoma is the lowering of the intraocular pressure. No matter how successful any treatment may be for a patient with glaucoma, the condition is never considered cured, only adequately treated. For this reason, and for the reason that damage is irreversible, regular follow-up visits are critical to ensure control of this condition.

The lowering of intraocular pressure is most commonly achieved through the regular use of prescription eyedrops, which must be taken on a regular and continual basis in order to be considered an effective treatment. An equivalent alternative treatment which can be safely used in most cases of glaucoma, is laser trabeculoplasty, an office-based procedure covered by provincial health care. Glaucoma surgery is also an effective treatment for glaucoma, and the procedures range from micro-invasive glaucoma surgery (MIGS), to diode laser cyclophotocoagulation, to tube shunts, to trabeculoplasty.