Glaucoma - What is Glaucoma?

An explanation by Dr. Aleksic’s treatment centre optometrist, Rianda.
Dr. Zoran Aleksic FCS (SA) Ophth, is an eye surgeon and Ophthalmologist specialising in cataract and laser refractive surgery (Lasik / PRK laser refractive surgery for short sightedness, far sightedness and astigmatism). Dr. Aleksic’s treatment centre is located in Sea Point in Cape Town.
Dr. Zoran Aleksic and his team have long been recognised both in South Africa and the rest of the continent for providing high quality eye care with a full spectrum of treatments, from prescribing glasses and contact lenses to complex and delicate eye surgery using the latest technological equipment, all in a relaxed and professional environment.
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Transcript:
Glaucoma is an eye condition which occurs when pressure inside your eye is too high and by too high I mean it's causing damage to your optic nerve. There may be several reasons why your pressure is too high. It can be because your eye is producing too much fluid and can't drain quick enough or it's producing the right amount of fluid but the drainage system is compromised. What actually happens is the pressure builds up to a certain level and then it presses onto your optic nerve. You can imagine if you press on anything on your body for years and years without knowing; eventually there will be an indentation.
The important thing to know about Glaucoma is that you can't feel it. That's why it's important, especially if you're over the age of 40 to yearly check your pressure. Also if you have a family history of someone with it, it's more important for you to regularly check intraocular pressure. To measure the intraocular pressure, we measure this daily when every patient comes in. We put a local anesthetic drop in your eye. It numbs the eye after about 20 seconds. Dr. Aleksic uses what we call an applanation tonometer. It's not the one that you experience at an optometric practice when we blow a bit of air like an air puff into your eye. This is more accurate and it doesn't touch your eye. It touches the tear film of your eye. The normal pressure is between 11 and 21. Now even when you're on the higher end of the spectrum we need to make sure that the pressure that we are measuring is low enough for your eyes.
There are other things that Dr. Aleksic can look at as well in order to determine whether this is a normal pressure for your anatomy. The next thing that we will do, is he'll do what we call a ophthalmoscope. That is when he in your eye and he looks at your actual nerve and you can see then whether it's been indented or whether it's a normal size, with a normal contour and and it looks healthy. In that case it might be that even whether your pressure is on the higher end of the spectrum it is still normal for your eyes anatomy. But, let's assume that the pressure is too high, such as 25, 26. Dr. Aleksic looks into the back of your eye and he sees suspicious signs of of your optic nerve being damaged. Then there are a few things that you will need to do on a regular basis. We will need to establish trends - to do a certain thing now as a baseline reference.
The first thing that we'll do after if we suspect that you have glaucoma is to measure the thickness of your cornea. In a case where you have a thicker cornea, we need to adjust the pressure but then you can imagine a thicker cornea will be a bit more resistant so we need to maybe subtract from our amount that we measured initially. If you have a thinner cornea we might need to add to the pressure in order to get to an accurate number. The next thing that we want to do is we want to test the function of your nerve. Now how it works is you have the optic nerve at the back and that connects the eye to your visual part of your brain, so we want to test the functionality of this nerve. The first sign that the pressure is too high and it's causing damage and your eyes not functioning to an optimal level is when you experience that your peripheral sight gets smaller and smaller. Peripheral sight that is lost cannot be reversed so when you start to notice it it's; already been there for a while so we want to have it here or in the normal range and then prevent it from damaging your peripheral vision.