Glaucoma is a disease that causes damage to the optic nerve and can result in irreversible loss of vision, starting from peripheral vision then central vision. Commonly, though not always, the cause for damage is elevated intraocular pressure (IOP). Although the exact mechanism is still unknown, it is considered to be a fluid exchange issue inside the eye. Glaucoma is the second leading cause of blindness and any vision loss that takes place will be permanent and cannot be recovered, which is why early diagnosis and treatment is essential.
Each patient and each eye is different and therefore it is difficult to determine a general range for 'normal IOP'. Usually, an IOP between approximately 10-20 mmHg is cited as 'normal' but it is important to note that for some patients even a low or normal IOP can be 'too high' and vice versa for some patients a 'high IOP' may not cause glaucomatous changes. Please note that IOP is different from systemic blood pressure (BP) although there may be a correlation between the two.
Glaucoma is often called "the silent thief of sight" since it can develop without any signs or symptoms until damage has already happened, which cannot be reversed - vision loss is permanent. With very high IOP vision may become blurry. In extreme cases, a dangerously high IOP ("closed-angle glaucoma attack") can lead a patient to the emergency room with complaint of vomiting and stomach pain. Eventually, untreated glaucoma leads to irreversible narrowing of the visual field and loss of vision.
There are associations between the glaucoma and the following risk factors:
Although it may not be possible to prevent glaucoma entirely, the following have been linked to better eye health and reduced IOP:
Since elevated IOP is a common factor for glaucomatous changes, the first check is a simple IOP measurement. As mentioned before, however, an IOP measurement is not the only indication because of individual differences and the complex nature of glaucoma. A thorough ophthalmological examination by your ophthalmologist should be done, including the optic nerve as well as any anatomical irregularities. It is advised to have your IOP checked even if you do not belong to any of the risk groups due to the "silent" nature of development. If glaucoma suspicion is raised, further evaluation will be advised accordingly. Please note that glaucoma can develop from a young age.
At Finland Eye Center, we have the tools to diagnose and follow-up glaucoma, including:
There are several options for glaucoma treatment from medication to surgery, depending on the patient's condition and circumstances. The aim of glaucoma treatment is to lower IOP, usually by a 20% reduction at least. At Finland Eye Center, we offer a range of options:
Your ophthalmologist will discuss your treatment options with you and decide on the most appropriate method for your individual needs. In general, medication (eye drops or tablets) used to be the first line of treatment. It is a non-invasive option to reduce IOP. However, it must be understood that glaucoma medication is a daily medication that needs to be continued for the rest of your life with regular follow-up to ensure appropriate dosage. Currently, the trend is moving towards surgical options earlier, which offer long-term results without daily concerns or compliance issues (i.e. patients who do not use their medications as prescribed). For example, the latest surgical technique is the ExPress tube - a mini shunt placed in the eye for drainage - which was brought to Oman first by FEC. For patients needing both cataract surgery and glaucoma surgery, a combination procedure can be done in one session.
Note: If glaucoma has advanced too far, vision loss and blindness can occur regardless of treatment due to the previously mentioned irreversibility of glaucomatous changes. In such cases, any treatment would be ineffective.
Lifelong glaucoma medication may cause dry eyes, foreign body sensation, redness, itching, or allergy. Changes in iris colour towards more brown (even in blue-eyed patients) and strengthening of eye lashes is common. Shortness of breath can occur, which can worsen asthma or lead to an asthma attack (in patients who are asthmatic). Rarely, systemic effects are possible such as bradycardia or irregular heartbeat. Glaucoma medication must be used as prescribed with regular follow-up. If the IOP does not reduce to an acceptable level with medication, surgical options will be considered.
As with all surgeries, glaucoma surgeries carry risks and side effects from anaesthesia to intra-operative complications and post-operative recovery. Your anaesthesiologist will examine you and decide the best anesthesia option for you (local, general) based on your health status. Should circumstances arise during surgery, which require immediate decisions, your surgeon has the right to change the surgical plan intra-operatively for the best of the patient. Post-operative risks include temporary blurred vision, foreign body sensation, redness, infections (immediate or late), and temporary vision reduction (should improve within a few weeks). Follow-up is essential to monitor and remove sutures and treat any post-operative complications as soon as possible. In some cases, the healing of tissues is 'too fast' and revision of the surgery site may be needed. It is possible that the chosen method proves ineffective at reducing the IOP to an acceptable level despite successful surgery. In these situations further treatment may be needed (simultaneous medication, further surgeries).
Note: Glaucoma diagnosis, treatment and follow-up involve many steps. Each of these steps requires care and co-operation from all involved. While all effort is made to ensure successful surgery (should surgery be decided), it is important to make an informed decision, before signing the consent form.
Finland Eye Center is the first venture in Oman and the Middle East by a Finnish group of medical field experts who have already established several eye centers within Europe. Finland Eye Centre strives to provide world class quality eye care, always keeping patient safety and satisfaction as a priority.
Al Qurum / Qurum Garden Building. Opp Qurum Park/ First Floor
Talk to Us:
+968 24564488
Info@finlandeyecenter.com
