Glaucoma is one of the commonest diseases affecting the eye. In this condition elevated pressure develops in the eye due to inadequate drainage of the fluid at the front of the eye (aqueous humour). This increased pressure is transmitted to the back of the eye causing damage to the optic nerve. Neurons that transmit visual information from the eye to be interpreted by the brain are carried in the the optic nerve so any damage leads to a loss of vision. Diagnosis needs to be made accurately as treatment is usually continued for life. Mr Yadav has many years of experience managing glaucoma. Through his role as director of emergency eye care for the whole of Shropshire, Mr Yadav deals with the most complex and acute cases every week. 

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What is glaucoma?

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Glaucoma is the name given to a group of eye diseases that damage the optic nerve. The optic nerve transfers visual information from the eye to the brain and damage to this can result in sight loss and even blindness.  Glaucoma can be acute where the pressure suddenly rises or chronic where the pressure increases over time. It can also be present from birth where this is called congenital glaucoma. 

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What causes glaucoma?

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Anyone can develop glaucoma but there are several risk factors which make it more likely to develop. These include age, high blood pressure, ethnicity, genetics, being short-sighted (chronic open-angle glaucoma) or long-sighted (acute angle-closure glaucoma) and diabetes. 

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How is glaucoma treated?

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Treatment depends on the type of glaucoma that is diagnosed and in the first instance you may just be monitored (ocular hypertension and glaucoma suspect patients). All treatment is aimed at lowering the eye pressure and the most common treatment is with eye drops. Some patients undergo laser and even glaucoma surgery. Mr Yadav will advise you on the best treatment option for you.  

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Will glaucoma improve without treatment?

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No. Acute glaucoma always needs treatment to prevent permanent blindness. In general, patients with chronic glaucoma continue to lose their field of vision gradually if their eye pressure stays too high. However, this loss of visual field can occur at different rates for different patients.

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I have glaucoma but my vision is fine and my eyes feel normal. Why do I need treatment?

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People with chronic glaucoma are usually unaware of any problems early in the disease. Initially vision is only lost from the very peripheral visual field which is hard to notice without a formal visual fields test. However, the visual field will continue to be lost over time until eventually even the central visual field is affected and the eye becomes blind. Another way of thinking about is that we treat high blood pressure to stop the risk of a heart attack. The high blood pressure is doing cumulative damage to your organs such as the heart but you may not notice this until you've had a heart attack by which time it is too late. 

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