Access the expertise of an experienced glaucoma specialist

As 50% of Australians with glaucoma go undiagnosed, resulting in irreversible vision loss, timely detection and treatment are paramount. At Mornington Peninsula Eye Clinic, we’re proud to provide our community with expert care from a highly skilled glaucoma specialist.

Glaucoma is a type of optic neuropathy, meaning a disease of the optic nerve. If left untreated, vision loss from glaucoma is progressive and any such loss from nerve damage is irreversible, even with eventual glaucoma treatment. There are several reputable ophthalmologists with an interest in glaucoma subspecialty, however, the typical asymptomatic nature of glaucoma often results in the delay of timely referral to an appropriate glaucoma specialist.

At a basic level, glaucoma occurs when the intraocular pressure of the eye is too high for the health of the optic nerve, causing damage and loss of nerve fibres. This level of pressure at which potential damage may occur varies between individuals and is also affected by other factors, including anatomical variations and co-existing systemic disease.

Glaucoma cases are divided into two broad categories: open-angle or angle-closure glaucoma. These classifications refer to the configuration of the iris against the cornea as the point where these two structures meet to form the drainage of fluid from within the eye, an area known as the anterior angle. The control of intraocular pressure is largely determined by the balance of fluid production to fluid drainage within the eyeball; an upset to this balance can result in an increase of pressure and subsequent glaucoma. Open-angle glaucoma includes situations where the anterior angle is wide but fluid drainage is hindered for other reasons while angle-closure refers to the iris being too closely positioned to the cornea, narrowing the anterior angle and impeding fluid drainage.

Who is at higher risk of developing glaucoma

Glaucoma can affect anyone, but some people carry considerably more risk than others. Knowing where you sit determines how often your eyes should be examined.

Family history is the strongest single factor. Glaucoma Australia, citing NHMRC guidelines, notes that first-degree relatives, parents, siblings and children of a person with glaucoma are at around ten times greater risk than the general population. If you have been diagnosed, tell your family members.

Other recognised risk factors include:

Age over 50
Elevated eye pressure, or ocular hypertension
Short-sightedness
Thin corneas
Diabetes
High blood pressure
Long-term steroid use
Previous eye injury
Being of Asian or African descent

Glaucoma Australia recommends that Australians aged 50 and over have a comprehensive eye exam every two years, and that those with a family history, or of Asian or African descent, start earlier and attend more often.

Having one or more of these factors does not mean you will develop glaucoma. It means an eye examination is worth booking rather than deferring.

Early symptoms, and why glaucoma is so often missed

Glaucoma is often called the silent thief of sight, and the name is accurate. In its early stages, primary open-angle glaucoma, the most common form, produces no pain, no redness and no noticeable blurred vision. Damage to the optic nerve is already underway while vision still feels entirely normal.

The first area affected is usually peripheral vision, at the outer edges of your visual field. The brain compensates so effectively that most people notice nothing until a substantial amount of nerve tissue has been lost. By then, the damage is permanent.

Acute angle-closure glaucoma behaves very differently. A sudden, steep rise in eye pressure causes severe eye pain, redness, blurred vision, halos around lights, headache and nausea. This is a medical emergency requiring immediate attention.

Because the common form gives no early signs, early detection depends on examination rather than on symptoms.

How glaucoma is diagnosed

A glaucoma diagnosis is not made from a single reading. It is built from several measurements considered together, because eye pressure on its own neither confirms nor excludes the disease.

A glaucoma assessment in our rooms generally includes:

Eye pressure measurement (tonometry). This records your intraocular pressure (IOP). Pressure fluctuates through the day and differs between individuals, so a single number is interpreted in context rather than in isolation.

Optic nerve examination. Your ophthalmologist examines the optic nerve head directly, looking for the structural changes characteristic of glaucoma damage.

Optical coherence tomography (OCT). This scan measures the thickness of the retinal nerve fibre layer, the bundle of fibres that carries visual information from the eye to the brain. Thinning can be detected before any vision is lost, which makes OCT a powerful tool for identifying early-stage glaucoma.

Visual field test. This maps your peripheral vision and identifies gaps you would not notice yourself. It also establishes the baseline against which every future test is compared.

Gonioscopy. A specialised lens is used to view the drainage angle where the iris meets the cornea. This distinguishes open angle from angle-closure glaucoma, and directly shapes which treatment is appropriate.

Corneal thickness (pachymetry). Thin corneas affect the accuracy of pressure readings and independently raise risk.

Together, these build a picture of your overall eye health and establish whether glaucoma is present, which type it is, and how far it has progressed.

Glaucoma Management

At Mornington Peninsula Eye Clinic, we have worked hard to provide highly skilled glaucoma management to our patients. Our glaucoma surgeons have undergone extensive subspecialty training both locally and internationally, bringing to you modern research and knowledge in glaucoma treatment in our facilities.

Our rooms are equipped with cutting-edge diagnostics, including visual field testing and optical coherence tomography, allowing glaucoma diagnosis and management with precision. Patients diagnosed with glaucoma will be counselled on treatment options with our experienced specialist. Your recommended management strategy will be based on several factors that your ophthalmologist will discuss with you. These include:

Other existing eye or systemic diseases
Your ability to adhere to medication dosing schedules
The likelihood that a certain treatment will provide sufficient intraocular pressure control

Currently, there is no cure for glaucoma, but further vision loss can be slowed or halted with timely and appropriate glaucoma management. Our specialists are committed to staying at the forefront of developments in glaucoma treatment, and at Mornington Peninsula Eye Clinic, we aim to bring this knowledge to you. Management options that your ophthalmologist may discuss with you include:

Therapeutic eye drops

Various pharmaceutical medications have been shown to effectively lower intraocular pressure. Anti-glaucoma eye drops are a life-long treatment and will need to be instilled at least once a day. Some patients with aggressive glaucoma may require more than one type of topical eye drop medication.

Prescription eye drops work either by reducing fluid production inside the eye or by helping fluid drain more efficiently. Because they lower pressure only while they are being used, taking them consistently matters as much as the prescription itself. Oral medications are sometimes used alongside drops, usually for short periods or where pressure needs to be brought down quickly.

Laser therapy

Laser treatment can be applied to both open-angle and angle-closure glaucoma. A procedure known as a laser iridotomy can be performed to even prevent the onset of angle-closure glaucoma if your eye doctor determines that you are at high risk. In open-angle glaucoma, laser therapy known as SLT can be applied to improve the fluid outflow through the anterior angle. In some cases, SLT may need to be repeated if the effects wear off after several years.

Laser treatments are performed in our rooms rather than in an operating theatre. The treatment itself is brief, and most patients experience minimal discomfort. Laser may be used as a first-line option or alongside eye drops, depending on how your eye pressure responds.

Surgery

Current ophthalmology research is looking into surgical options for glaucoma treatment, and has come a long way since surgical techniques were first employed to manage this disease. The advent of MIGS, or minimally invasive glaucoma surgery, has shown promising results for glaucoma management, demonstrating significant and sustained reduction of intraocular pressure. For many patients who are not keen on the idea of life-long medications, MIGS can be an attractive option.

MIGS procedures use tiny incisions and small implants to improve fluid drainage from the eye. They are frequently performed at the same time as cataract surgery, and are generally considered for mild to moderate glaucoma. Compared with traditional glaucoma surgery, MIGS carries less risk and a shorter recovery, though the pressure reduction is usually more modest.

Where glaucoma is more advanced, or where pressure remains uncontrolled despite drops and laser, established surgical procedures remain important. A trabeculectomy creates a new drainage channel in the wall of the eye, bypassing the obstructed drainage angle. Drainage implants, small tubes placed within the eye, achieve the same result by a different route. Your surgeon will explain which approach is clinically appropriate for your eyes, and what to expect before, during and after.

Ongoing monitoring and long-term management

Glaucoma is a lifelong condition. Beginning treatment is the start of managing glaucoma, not the end of it.

Two things are assessed at every review: whether your eye pressure is sitting at the target set for your eyes, and whether the optic nerve or visual field has changed since last time. Pressure can be measured at a single visit. Progression cannot, it only becomes visible when today’s OCT scan and visual field test are compared against your previous results. This is why repeat testing matters even when nothing feels different.

How often you are reviewed depends on how advanced the disease is, how well pressure is controlled, and the overall level of risk the ophthalmologist judges you to carry. Some patients are seen twice a year, others more frequently, particularly in the period following a change to treatment.

A treatment plan is adjusted over time rather than set once. Drops may be added, changed, or replaced by laser therapy or surgery if pressure drifts upward or the visual field continues to change. Adherence is discussed openly, because drops that are difficult to instil or easy to forget are a common and correctable reason for poor pressure control.

Throughout, the focus is vision preservation: lowering intraocular pressure, preventing progression, and protecting long-term vision. Sight already lost to glaucoma cannot be recovered, but with consistent monitoring and appropriate treatment, further loss can often be slowed or halted.

Specialist glaucoma care at Mornington Peninsula Eye Clinic

Mornington Peninsula Eye Clinic provides general and subspecialty ophthalmology within one practice, with over 10 years’ experience caring for patients across the Peninsula and greater Melbourne. Our surgeons are associated with The Royal Victorian Eye and Ear Hospital, including its glaucoma unit.

That breadth matters in glaucoma care. Patients often present with more than one condition, glaucoma alongside cataract, diabetic eye disease or a retinal problem, and those treatment decisions interact. Managing them in one practice means your care is coordinated rather than split across referrals.

Book an appointment today with our experienced glaucoma doctors at Mornington Peninsula Eye Clinic.

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