Why early detection in glaucoma care is critical

Farah Topia

Clinical Adviser, Association of Optometrists

Glaucoma is a term given to a group of largely chronic conditions that damage the optic nerve at the back of the eye, which, if left untreated, can lead to permanent sight loss.

Despite these significant and life-altering effects, glaucoma may not have symptoms, particularly in the early stages, so the importance of regular sight tests to prevent avoidable vision loss cannot be understated.

Glaucoma risk factors

Although age is the greatest risk factor, other factors can also increase your risk. Having family members with glaucoma or being of black African or black Caribbean ethnic origin could potentially place you at an increased risk. Other conditions, such as diabetes, are also a risk factor.

The two main types of glaucoma come with varied symptoms. Closed-angle glaucoma can develop symptoms quickly, including, red and painful eyes, headaches, nausea and coloured halos around lights. Open-angle glaucoma is typically slow onset, with no pain or symptoms in early stages.

There may only be minimal changes to your eyesight, but peripheral vision could be compromised. This can eventually affect your central vision as well. You should have regular sight tests to enable early detection and referral for treatment to prevent disease progression, as once sight is lost, this is irreversible.

The two main types of glaucoma
come with varied symptoms.

Treatment matters

Open-angle glaucoma is typically treated by laser or with daily eye drops; both aim to reduce pressure in the eye. In some cases, surgery may be necessary to control the pressure. As closed-angle glaucoma can progress quickly and lead to lasting damage, it is initially treated with eye drops and tablets; occasionally, medicine is injected directly into the bloodstream to reduce pressure in the eye quickly.

Laser treatment is also often used for closed-angle glaucoma to improve flow of fluid within the eye and reduce eye pressure. If this is unsuccessful, surgery may be required.

Care in the community

Currently, most patients with glaucoma are monitored within hospital eye departments. These visits happen multiple times a year, and patients are often reliant on public transport or friends and family to get them to hospital appointments as examinations often involve pupil dilating drops that blur vision.

Greater access to community monitoring via high street opticians gives patients access to necessary care closer to home rather than in a busy hospital environment. While many optometrists are trained to provide this type of clinical care, unfortunately, these schemes are not available everywhere.

At the Association of Optometrists, we’re calling on the Government to change glaucoma care for patients so that patients can access a monitoring service near where they live.