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Glaucoma is a common disease of the eye which can lead to irreversible loss of vision and blindness. Many people are unaware that they have glaucoma as the disease has no symptoms. Therefore early detection, diagnosis and treatment is imperative to preserve your vision.


Types of Glaucoma:

There are several types of glaucoma – such as congenital glaucoma, narrow angle glaucoma, secondary glaucoma, however the most common type of glaucoma is Primary Open Angle Glaucoma (POAG). In the normal eye, nutrient fluid is produced in the cilliary body behind the lens and exits the eye through small channels in a structure called the trabecular meshwork at the front of the eye. In Glaucoma patients , the fluid cannot leave the eye quickly enough and this leads to a build up of pressure inside the eye. This pressure can damage the optic nerve. As the optic nerve carries vision signals from the eye to the brain, damage to the nerve leads to a loss of vision.


How common is Glaucoma:

Approximately 1 in 50 of 40yr old people have a glaucoma related problem. This rises to 1 in 10 of over 75yr olds. People with one or more close family members with glaucoma are more likely to have the condition themselves and should therefore seek professional advice.


Who is at risk:

Risk factors for glaucoma include:

Ø  High pressure in the eye

Ø  Age over 40yrs

Ø  African ethnicity

Ø  Short sight

Ø  Very long sight

Ø  Diabetes

Ø  Poorly controlled blood pressure (very high or very low blood pressure)

Ø  A long history of migraines

Ø  People who have been using steroid medications for a long time


How do I know if I have glaucoma:

In the early stages, glaucoma affects the peripheral vision, and the central vision is unaffected. Therefore people often don’t have any symptoms and are completely unaware that they have glaucoma. One only becomes aware of a problem when a large portion of the vision has been lost.


Glaucoma is often first diagnosed on a routine visit to the opitician – often when patients go for their first reading spectacles in their 40s. Therefore having an eye examination by an optician or eye doctor is an important  part of looking after yourself as you get older, and even more important if you have one or more of the risk factors mentioned above.


What happens at the examination:

Mr Bhermi will ask you about any eye symptoms you may have, ask about your general medical health (as this can be connected to various eye diseases) and perform a detailed examination of your eyes. Common investigations for glaucoma include:

Ø  Measuring the level of vision

Ø  Examining the eye on a slit-lamp

Ø  Measuring the intraocular pressure with a Goldman tonometer

Ø  Assessing the trabecular meshwork and drainage angle of the eye with a Gonioscope

Ø  Measuring the corneal thickness with an ultrasound scan.

Ø  Examining the health of the optic nerve

Ø  Taking an image or scan of the optic nerve if necessary.

Ø  Assessing the health of the peripheral vision by performing a Humphrey Visual Field test.


Mr Bhermi will discuss the results with you and formulate a management plan which is tailored to your individual needs



What treatments are available:

There is no cure for Glaucoma, however,  the disease can be managed to prevent loss of vision and blindness. If you have high pressure in your eye(s) and are at risk of damaging your vision, the aim of treatment is to lower the eye pressure to a level where damage is unlikely to continue. If damage has occurred by the time you are first diagnosed with glaucoma, the aim of treatment is to prevent further vision loss.

Treatment options fall into three categories:

Ø  Drops

Ø  Laser Treatment

Ø  Sugery


There are many possibilities in each catergory and these can be discussed and individualised at your consultation with Mr Bhermi.



Is there anything I can do as a patient ?:

 If you feel that you are at risk, it is advisable to have a check-up at the optician or with Mr Bhermi.

If you are prescribed glaucoma drops, it is important to comply with the treatment regime and use the drops as instructed. This usually means that you will need to continue with them unless you are advised otherwise. You will also need periodic check-ups to ensure that the treatment is working and that your condition is stable. It is therefore important not to miss your follow-up appointments.



If you have any questions, please do not hesitate to contact Mr Bhermi’s office.



International Glaucoma Association:

The Glaucoma Foundation: