Eye drops
Daily pressure-lowering drops, alone or combined. There are many drug families, and the choice is tailored to each patient.
Home · Treatments · Glaucoma
The silent disease of the optic nerve
Glaucoma: the disease that gives no warning.
It is the leading cause of irreversible blindness worldwide. In its early stages it causes no pain or discomfort, which is why regular screening from the age of 40 — or earlier if it runs in the family — is so important.
What is glaucoma?
Glaucoma is a chronic disease that progressively damages the optic nerve, which carries images from the eye to the brain. The most common cause is raised eye pressure pressing on the nerve fibres.
Vision loss starts at the edge of the visual field and progresses very slowly, so many people do not notice it until the disease is advanced. The good news: detected in time, glaucoma can be well controlled and sight loss prevented.
Who should be checked?
- Everyone over 40: a check every 2–3 years, even without symptoms.
- Family history of glaucoma: a yearly check from the age of 35.
- High myopia (more than −6 dioptres).
- People with diabetes, high blood pressure or long-term steroid treatment.
- African-Caribbean or Asian heritage.
- A previous eye injury or uveitis.
How we diagnose it
Glaucoma is not diagnosed with a single test. We need a set of examinations, all done in the same visit:
- Tonometry: measuring the eye pressure.
- Pachymetry: corneal thickness, which affects how the pressure is interpreted.
- OCT of the optic nerve and nerve fibre layer: a scan that measures structural damage.
- Visual field test: checks for functional defects in your vision.
- Gonioscopy: examination of the eye's drainage angle.
- Retinal photography and fundus examination with assessment of the optic nerve.
Treatment
Glaucoma treatment is stepped according to severity and how each patient responds:
SLT laser
Selective laser trabeculoplasty. A painless outpatient procedure that improves fluid drainage. Increasingly used as first-line treatment.
Glaucoma surgery
When the above does not control the disease. There are traditional techniques (trabeculectomy) and minimally invasive ones (MIGS), chosen case by case.
Acute glaucoma: an eye emergency
There is a form of angle-closure glaucoma that does cause striking symptoms: severe eye pain, blurred vision, halos around lights, nausea and vomiting. It needs immediate care to lower the pressure and prevent permanent damage. If you have these symptoms, go to the nearest emergency department.
Second opinion on your treatment
If you are already being treated for glaucoma and are unsure about your diagnosis, your drops or a proposed operation, you can send your visual fields, OCT scans and pressure readings for an online second opinion in English.
Frequently asked questions
Can glaucoma be cured?
No. It is a chronic disease that is controlled for life. The good news is that, when well controlled, it does not cause significant sight loss in most patients.
If my eye pressure is high, do I already have glaucoma?
Not necessarily. High eye pressure (ocular hypertension) is an important risk factor, but not everyone with high pressure develops glaucoma. That is why the optic nerve is also assessed with OCT and visual field tests.
Do the eye drops have side effects?
Some can cause irritation, red eyes or a change in iris colour. There are many options, and if one does not suit you we can try others until we find the one you tolerate best.