Don’t be blinded, get tested early

2018-06-27 06:03

Every day that I spend at my practice, I come across true stories, but also old wives’ tales.

The following sentence remains one of the hardest to say to a patient: “If you had only come to me sooner, I might have been able to help.”

Glaucoma is quite a common condition, which 3% to 5% of people will develop in their lifetime.

This neuropathy of the optic nerve can come like a thief in the night, causing blindness – and the patient would be none the wiser, in the beginning.

A small percentage of glaucoma cases are hereditary; thus, it is essential for people with a family history to go for regular check-ups, especially since glaucoma becomes more prevalent after the age of 40.

Your vision would seem excellent right into the late stages of the condition and you would experience no pain.

There is a small category of glaucoma cases in which pressure would increase rapidly, which would cause intense pain.

Prevention and awareness of glaucoma is essential, because it is an incurable disease.

It can, however, be controlled.

Certain eye conditions, such as myopia (nearsightedness) and hypermetropia (farsightedness) are risk factors.

Systemic conditions like hypertension (high blood pressure) and diabetes may also contribute to the risk of developing glaucoma.

The most common type is primary open-angle glaucoma.

A glaucoma examination unfortunately does not entail only an eye pressure test (tonometry). The structure of the nerve, as well as the function, is also examined.

There are numerous ways in which eye pressure can be determined.

It is my belief that as soon as a diagnosis has been made, it is best to have the pressure as close to ten as possible.

Unfortunately, there are people who do have a low pressure, but still have glaucoma, due to abnormalities in their optic nerve and their visual field.

We will have a look at the thickness of your eye’s cornea once a year, which we call pachymetry, which would determine if the pressure that was taken, could be considered reliable.

The angle structure through which the eye fluid drains is evaluated, with diagnostic contact lens gonioscopy.

The optic nerve can almost be compared to a vehicle tyre.

Every person has their own width “tyre” around their own size “rim”.

We use the OCT/HRT to evaluate the structure, enabling us to pick up on even the smallest of changes.

Finally, the functional tests are done, the field of vision. During this test, you look with one eye at a time, determining whether you have side vision to the side of the nose and the side of the ear.

Treatment usually starts with drops that must be administered daily, some once a day, others twice a day.

When your doctor realises that the structure or function decreases with drops as treatment, surgery is usually suggested.

The first line of defence is the minimal intervention, the so-called “MIGS” surgery; thus if your condition is not too far progressed or if you seem to be allergic to drops, this would be the route to follow.

There are numerous other filtering procedures available, such as trabeculectomy and structures that are placed in.

Each patient is unique and has a unique condition and the treating ophthalmologist would be able to choose the best route of treatment for the patient’s eye.

Research is currently being done to inject biodegradable medication into the eye twice annually.

This route is being investigated to obtain the co-operation of the patient, as well as to have better control over the treatment.

Dr Lynette Venter


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