Glaucoma

Moorfields Private is at the forefront of research into glaucoma, and we are always ready to help patients determine the best course of action when faced with this condition.

Although there is no cure for glaucoma, it can be effectively managed and sight loss minimised.

We are experts at controlling the effects of glaucoma through innovative treatments and experienced clinical care. Moorfields Private counts some of the world’s leading glaucoma researchers and clinicians among its staff, and will be happy to talk to you about any aspect of your ongoing care.

Glaucoma is an eye condition characterised by loss of vision due to damage of the optic nerve. The optic nerve carries sight images to the brain, and any damage to the nerve results in damage to sight.

Usually, but not always, the damage occurs because pressure within the eye increases and presses on the nerve, which damages it.

The term 'glaucoma' actually covers several different conditions:

The most common is Chronic (primary open angle) glaucoma - this form usually affects both eyes and develops slowly so that loss of sight is gradual. There is no pain, redness of the eye or dramatic change in vision.

With Acute (angle closure) glaucoma, there is a sudden increase in the pressure within one eye. The eye becomes red and painful. Often there is mistiness of vision and episodes of seeing haloes around lights.

Sometimes, other diseases of the eye cause a rise in the pressure within the eye - this group of conditions is called secondary glaucoma.

You will not go blind if your glaucoma is diagnosed early enough and you follow your treatment as instructed. Any sight you have lost you will not regain, however, there is help and information available for people who have lost their sight through glaucoma.

Open angle glaucoma (chronic glaucoma)

There are usually no symptoms with chronic glaucoma because it occurs so slowly. People with this type of glaucoma often do not realise that their sight is being damaged. This is because the first part of the eye to be affected is the outer field of vision (peripheral vision). This often means that vision is lost from the outer part of one’s field of vision, slowly working inwards towards the centre.

Changes in vision are often linked to getting older, which is why regular eye checks are so important. It is recommended that people who are over 40 years of age have an eye test every two years.

Acute angle closure glaucoma (acute glaucoma)

Due to the rapid development of acute glaucoma, the symptoms are often severe. They include:

• intense pain,
• redness of the eye,
• headache,
• sore,
• tender eye area,
• seeing halos, or 'rainbow-like rings' around lights, and
• misty vision.

As a result of these symptoms, some people may experience nausea and vomiting.

The symptoms of acute glaucoma are not constant, and they can last a few hours before disappearing again. However, each time the symptoms occur, your vision is damaged a little more. It is important that you contact your GP straight away if you experience any of the above symptoms because early treatment can prevent further damage from occurring.

If you experience symptoms outside of your GP's normal working hours, visit your nearest accident and emergency (A&E) department. The healthcare staff will be able to relieve the pressure within your eye and treat any pain and discomfort that you are experiencing.

Secondary glaucoma

As secondary glaucoma is caused by other conditions, or eye injuries, it is possible that the symptoms of glaucoma itself may be confused with the original cause. However, the glaucoma may still cause misty vision, and rings, or halos, around light sources.

Glaucoma in children

Although glaucoma in children is very rare, there has been a specialist paediatric glaucoma service at Moorfields for over fifty years. The service is now run by Professor Peng T Khaw and Miss Maria Papadopoulos.

Developmental glaucoma (congenital glaucoma)

Recognising the symptoms of developmental glaucoma can be very difficult due to the young age of the baby, or child.

However, your child may display some symptoms, such as:

• having large eyes, due to pressure causing the eye to expand,
• being sensitive to light,
• having a cloudy appearance to their eyes,
• having watery eyes,
• jerky movements of the eyes, and
• having a squint, which is an eye condition that causes one of the eyes to turn inwards, outwards, or upwards, while the other eye looks forward.

If you notice any of these symptoms, you should visit your GP as soon as possible, or consult an optician.

How the eye works

The eyeball is filled with a watery substance called aqueous humour, which creates pressure in the eye to give it shape. In healthy eyes, this fluid constantly flows in and out of the eye to nourish it. It drains back into the bloodstream at the same rate that it is produced in order to maintain the correct pressure.

Glaucoma occurs when the drainage tubes (trabecular meshwork) within the eye become slightly blocked, preventing the aqueous humour from draining properly. It can also occur if there is an obstruction within the eye.

An obstruction within the eye, such as a blood vessel blocking the trabecular meshwork, can also prevent fluid from draining properly.

When the fluid cannot drain properly, the pressure in the eye builds up and can cause damage to the optic nerves, and the nerve fibres from the retina.

It is unknown why the drainage tubes get blocked, or why other parts of the eye obstruct the tubes.

Other causes

There are various other factors that can lead to glaucoma. These are listed below.

• Age - chronic glaucoma becomes more likely as you get older, affecting about 1% of people who are between the ages of 40-65, and 5% of people who are over 65 years of age.
• Ethnic origin - people of African, or Afro-Caribbean origin, tend to have a greater chance of developing chronic glaucoma. Also, people of Asian origin are more likely to develop acute glaucoma.
• Short sightedness - people who are short-sighted are more likely to develop to chronic glaucoma.
• Family history - if you have a close relative, such as a parent, brother, or sister who has glaucoma, you may also have a increased chance of developing the condition yourself. You should therefore have regular eye tests in order to monitor the condition of your eyes.
• Medical history - research suggests that people with diabetes are also more likely to develop glaucoma than those without the condition.

You do not need a GP’s written referral letter to see a Moorfields Private consultant. If you know which consultant you would like to see, please contact their private secretary to make an appointment or receive further information, alternatively, email us at enquiries@moorfields-private.co.uk