What is Glaucoma?
Glaucoma is an eye disease in which fluid pressure within your eye becomes too high, damaging the delicate fibres of the optic nerve which carries visual impulses from your eye to the brain. This damage is irreversible and can lead to blindness in advanced cases. Glaucoma accounts for 40 per cent of blindness in Singapore.
What causes Glaucoma?
The excessive pressure build-up in your eye occurs because of an imbalance between fluid production and its drainage within the eye. There are different types of glaucoma.
Primary open-angle glaucoma accounts for the majority of the cases. It affects the elderly and those who are middle-aged. The glaucoma progresses slowly and painlessly, so you may not notice that your vision is deteriorating. Peripheral and night vision will be affected before your central reading vision.
Acute angle closure glaucoma usually affects elderly and middle-age Chinese women in Singapore. The onset of this form of glaucoma is sudden with fluid pressure rising rapidly and dramatically in the eye. This results in eye pain and redness, headache and nausea. Other accompanying symptoms include blurred vision and seeing of coloured rings around lights.
Chronic angle-closure glaucoma progresses gradually and often goes unnoticed for a long time. It is caused by the progressive blockage of drainage channels in the eye causing a slow, prolonged rise in eye pressure.
Secondary glaucoma can be caused by inflammation in the eye or when a cataract becomes too advanced and swollen. Tumours, injuries and surgery may also cause secondary glaucoma.
How do I know if I have Glaucoma?
The disease can develop slowly and you may not be aware of the gradual loss of sight until very late in the disease when your vision is seriously affected.This is an interactive illustration demonstrating the loss of the field of vision at different stages of glaucoma severity.
However once a patient develops glaucoma, there is progressive optic nerve damage from the loss of healthy nerve fibres (see right box image), thus leading to progressive loss of the visual field.The patient will experience this as a progressive 'tunnelling' of vision or constriction of the field of vision .
What puts me at risk of Glaucoma?
• Age – your risk increases once you are over 50 years old. In Singapore, glaucoma affects about 3 percent of those aged over 50. This risk increases with age; the percentage of people aged over 70 affected by glaucoma is 10 percent
• Chronic diseases – you are at an increased risk of certain types of glaucoma if you have diabetes and high blood pressure
• Ethnicity – Asians and Afro-caribbeans are more susceptible to certain types of glaucoma than Caucasians
• Eye injuries
• Extreme nearsightedness or shortsightedness
• Family history
• Use of steroids
What can I do to prevent Glaucoma?
Most risk factors of glaucoma such as age, hereditary risk and race cannot be prevented. This means good eye health and regular eye examinations are important to detect the problem early. If you have a family history of glaucoma or are taking medications that put you at risk, regular eye examinations are essential (Find out the importance of an eye examination). Early diagnosis is the key to prevent blindness as glaucoma nerve damage is irreversible.
What kinds of treatments are available for Glaucoma?
Glaucoma cannot be cured, but it can be successfully controlled in most cases. Treatment depends on the type of glaucoma you are diagnosed with. It may be in the form of medication, laser therapy or surgery. After a discussion with you,Dr. Chua will determine the most appropriate treatment or procedure for you.