signs of glaucoma melbourne

Detecting the Signs of Glaucoma and Its Treatment Options

Glaucoma is an eye disease characterised by progressive damage to the optic nerve of the eye. It can occur in just one eye and not the other, or be present in both eyes but more advanced in one compared to the other. The optic nerve is responsible for carrying the signals received by the sensory cells of the retina at the back of the eye to the visual processing centres of the brain. Glaucoma is actually quite common – around 2 out of every 100 Australians have the disease. So, what is glaucoma and how is it treated? And are there any early signs of glaucoma you can look out for?

 

What is Glaucoma

Glaucoma is one condition in a category of eye diseases known as optic neuropathies. As mentioned earlier, glaucoma is diagnosed when the optic nerve is found to suffer progressive damage and loss of retinal nerve fibres. While the exact underlying causes of glaucoma are still yet to be fully understood, we know that at a basic level, optic nerve damage in this disease occurs because the pressure inside the eye, called the intraocular pressure, is too high for the health of the nerve. Typically, the normal intraocular pressure range is quoted as 10-21mmHg (millimetres of mercury), however, we can often find that people with pressures within this range still experience glaucoma, while a person with an intraocular pressure slightly over 21mmHg can still demonstrate a healthy, robust optic nerve with no signs of damage.

symptoms and signs of glaucoma melbourne and mornington peninsula

The intraocular pressure of the eye is determined by the balance of fluid production versus fluid drainage inside the eyeball. This fluid is known as aqueous humour.

If the production of aqueous humour is excessive, or if its drainage from the eye is impeded or slowed in some way, it can result in elevated intraocular pressures. It is common and entirely normal for the pressures of the eye to be asymmetrical, within about 3mmHg of each other, and for pressures to fluctuate throughout the day. Controlling the intraocular pressures underlies all forms of glaucoma treatment.

 

Risk factors for developing glaucoma include:

  • Older age
  • Family history of glaucoma
  • Short-sightedness (myopia)
  • Diabetes
  • Sleep apnoea

 

The Signs of Glaucoma

Unfortunately, most glaucoma cases in their early to moderate stages present with no symptoms, lending this eye disease the nickname of “the sneak thief of sight”. Despite being such a relatively common condition, around 50% of Australians with glaucoma are actually unaware they have it.

The optic nerve and retina of the eye contain no pain receptors so there is no pain or discomfort directly due to damage of the nerve. A small subcategory of glaucoma known as acute angle closure glaucoma can present with some noticeable symptoms, such as a very painful, red eye with blurred vision. This occurs when the intraocular pressures suddenly escalate to very high levels. However, the majority of glaucoma cases fall under another subcategory called open angle glaucoma, which results in a slower, more insidious pressure rise.

Ultimately, untreated glaucoma results in permanent vision loss. This typically begins in our peripheral vision, which is another reason why most people are delayed in realising when something is amiss. Unlike our central vision, we are often less aware of subtle changes to sensitivity in our peripheral field of view. When it comes to glaucoma, by the time we begin to realise our peripheral vision has deteriorated, the disease is already likely in its advanced stages.

Because glaucoma progresses so slowly and subtly, it is important to maintain regular eye exams with an eyecare practitioner even when you feel nothing is wrong with your eyes or vision. This gives you the best chance of catching the disease in its early stages before any significant vision loss, allowing the optometrist or ophthalmologist to implement appropriate glaucoma treatment to slow or prevent further deterioration. An eye examination is able to detect any signs of glaucoma even if the condition is in its early stages, and will involve tests including:treatment signs of glaucoma melbourne

  • Tonometry – a measurement of your intraocular pressure; this may be taken multiple times to observe how your pressures may change over time
  • Ophthalmoscopy – directly visualising the optic nerve to assess its features, such as colour, shape, and size
  • Optical coherence tomography – a retinal scan that can take important measurements such as the thickness of the retinal nerve fibre layer to detect any areas of thinning and damage
  • Perimetry – also known as visual field testing, this is an assessment of the sensitivity of your peripheral vision and is very useful for monitoring glaucoma progression and any associated vision loss

 

Glaucoma Treatment

Modern glaucoma therapies are fortunately quite effective in most cases, and a lot of research is being devoted into developing new treatments, particularly in an area known as “minimally invasive glaucoma surgery”, or MIGS. There are currently no treatments that can restore the vision loss incurred from glaucoma, however, the aim of therapy is to slow or halt any further loss.

Treatment options include medicated eye drops, laser treatment, and surgery, all of which aim to reduce the intraocular pressures to a level that maintains the health of the optic nerve. Not all therapies will be suitable or effective for all patients, but your treating doctor will work with you to find one that is the most appropriate.

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

 

macular degeneration treatment melbourne

What You Should Know About Macular Degeneration Treatment?

Age related macular degeneration is an eye disease with the potential to cause blindness. In fact, in Australia, it is considered to be the leading cause of legal blindness, contributing to half of all cases in our country. Unfortunately, even with retinal surgery, the loss of vision from macular degeneration cannot be completely reversed or cured, though with timely and appropriate macular degeneration treatment, it is possible to slow or reduce the risk of progression of the disease and further vision loss.

 

What is Macular Degeneration?

The macula of the eye is an anatomical area of the retina that encompasses your central vision. It differs from other areas of the retina in that it contains the highest density of cone photoreceptor cells, which are responsible for discerning fine detail and colour. This is why when we want to read or look directly at something, we turn our eyes to point the macula at the object of interest, making use of what’s considered the central vision. This is not to say that outside of the macula region we don’t perceive any vision – we’re just generally less attentive to our peripheral vision and unable to pick out fine details as effectively.

Because the photoreceptors of the macula are constantly responding to light and images entering the eye, they require a lot of energy and metabolic support. The retinal pigment epithelium, also known as the RPE, is the layer of cells that directly supports the photoreceptor layer of the retina, regulating the transport of nutrients and waste products as well as protecting the retina from damaging chemical reactions as a result of metabolic activity.

Age related macular degeneration and all its underlying factors are not yet fully understood, but it is known that damage to the retinal pigment epithelium plays a significant role in this disease. An eyecare practitioner, such as an optometrist or ophthalmologist, can see this during an examination as the formation of little bumps of accumulated waste material under the RPE, known as drusen. Eventually this leads to death (also known as atrophy) of these cells as well as the overlying photoreceptors reliant on the function of the retinal pigment epithelium, ultimately resulting in a decrease in vision in the affected part of the retina.

 

Macular Degeneration Treatment

surgery macular degeneration treatment melbourne and mornington peninsula

As mentioned earlier, there is no macular degeneration treatment that can totally reverse or undo the vision loss incurred once the disease has begun. However, there are options in macular degeneration treatment, including retinal surgery in very select cases, that aim to slow the progression of the condition and in some cases, has the potential to halt its deterioration, at least for a period of time.

There are two types of age related macular degeneration, and it’s important to identify which form is present in order to guide appropriate macular degeneration treatment and management. One is known as the dry form, which is characterised by the accumulation of drusen and subsequent atrophy. At this point in time, there is no known dry age related macular degeneration treatment. Instead, these cases are managed with nutritional and lifestyle advice in an effort to reduce the risk of further deterioration. This includes steps such as:

  • Quitting smoking
  • Implementing diligent UV protection for the eyes
  • A healthy diet of antioxidants, in particular zeaxanthin and lutein
  • Managing cardiovascular disease

The other type of age related macular degeneration is known as the wet form, or neovascular macular degeneration. This is defined by the formation of new blood vessels growing beneath the retina. These vessels are fragile and can leak blood and fluid into the surrounding tissues, causing scarring and significant vision loss.

Wet macular degeneration treatment options are a little better defined and often demonstrate good results in halting or dramatically slowing the deterioration of vision; in fact, there have been reports of some mild recovery of vision in certain cases. Injections into the eye of a medication known as anti-VEGF are the standard treatment for wet macular degeneration. This drug works by blocking the proteins produced in the eye that trigger the growth of new blood vessels. These injections are typically required to be administered multiple times over a certain period – some people require an injection every month to keep their condition under control, while others may be able extend their treatments to every 6 weeks or more.

Rarely are retinal surgery procedures used for the management of age related macular degeneration in modern ophthalmology. On occasion, a laser procedure known as photocoagulation may be employed alongside anti-VEGF injections in wet macular degeneration if the injections alone are insufficient to control the formation of new blood vessels.

During photocoagulation, a laser tool is used to purposely burn and scar small areas of the retina in order to seal off leaking blood vessels and prevent further uncontrolled vision loss. A problem with this treatment is that the laser scarring damages the retina by necessity, resulting in some degree of vision loss from the procedure itself.

Unfortunately, it is important to note that no macular degeneration treatment, including retinal surgery, can be guaranteed to be effective for all patients. As macular degeneration can begin with very subtle symptoms, it is important to maintain regular eye tests with your eyecare practitioner.

Contact us today at (03) 9070 3580 to schedule your next appointment!

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.