Eye conditions
Glaucoma
What is glaucoma?
Glaucoma is classified as a group of diseases which damage the Optic nerve. It is also known as the ‘silent thief of sight’ as in most cases, does not have any symptoms until late stages.
Glaucoma is usually related to elevated Intraocular (eye) pressure which damages the optic nerve, causes loss of peripheral visual field.
If left untreated, it can cause permanent vision loss eventually.
Glaucoma causes loss of peripheral visual field.
How common is glaucoma?
The two main types of glaucoma in Singapore are:
- Open – angle Glaucoma
- Closed – angle Glaucoma
3% of population in Singapore over 50 years of age and 7% over 70 years will develop this disease.
Glaucoma is the most common cause of irreversible blindness worldwide. It is more common in Chinese than Indian or Malay populations.
In Singaporean Chinese, 60% of adult blindness is caused by Glaucoma, and Singapore has one of the highest rates of closed-angle Glaucoma worldwide.
Angle – closure glaucoma occurs when aqueous fluid is unable to drain out from the eyeball. This can sometimes present as an emergency with very raised intra-ocular pressure when 3600 of angle within the eyeball becomes shut off, causing very rapidly to immediate loss of vision.
What causes glaucoma?
Glaucoma is a group of diseases that damage the eye’s optic nerve. The condition is generally not something you can feel, which may result in its going undiagnosed without proper checkups. If left untreated, glaucoma can worsen over time, leading to vision impairment and even blindness.
A major risk factor for developing glaucoma is increased eye pressure. Fluid inside the eye carries nutrients to the lens and cornea, then drains out through a natural filter called the trabecular meshwork. If the fluid cannot drain properly, it builds up, resulting in increased pressure inside the eye. Additional risk factors:
- Advanced age
- Severe myopia (near-sightedness)
- Poor blood circulation
- Genetics (having another family member with glaucoma)
Slow fluid drainage or restriction to outflow within the Eyeball.
Pressure builds up and damages the optic nerve.
Can occur at different pressure levels for different people.
Slow fluid drainage or restriction to outflow within the Eyeball.
Pressure builds up and damages the optic nerve.
Can occur at different pressure levels for different people.
Glaucoma causes loss of peripheral visual field.
Normal Vision
Vision with advanced Galucoma
Who is at higher risk of glaucoma?
- Everyone over 60 years of age
- Chinese race over 50 years, especially females
- Family history of glaucoma
- Previous eye surgery or trauma
How is Glaucoma detected?
With a comprehensive dilated eye examination.
Dr Natasha Lim will examine the drainage structure of your eye, the Optic nerve and Retina using a slit-lamp microscope.
People over 50 years of age are recommended to have glaucoma screening by an Eye Specialist like Dr Natasha Lim every 2 years.
People with risk factors for glaucoma such as family history or previous eye surgery should be examined every 1-2 years.
Can Glaucoma be prevented or improved?
Open angle glaucoma can only be detected and treated with drops and/or surgery.
Closed angles may be treated with laser iridotomies (A tiny hole is made in the Iris muscle using laser to allow fluid to drain from the eye) to prevent glaucoma from developing, by early cataract surgery if there is already the presence of a cataract.
Glaucoma is an irreversible disease and cannot be improved as damage to the optic nerve is permanent.
How is glaucoma treated?
With Eyedrops, Laser or Surgery depending on the type and severity of the condition.
- Pressure lowering eyedrops are usually put in once or twice daily to reduce the eye pressure.
- Selective Laser Trabeculoplasty (SLT) is done as a simple chair procedure to stimulate cells in the trabecular meshwork, lasting 15 minutes and is a painless procedure for treating primary open-angle glaucoma (POAG).
- YAG laser Peripheral Iridotomy (PI) for narrow-angle glaucoma (NAG).
- Micro-incisional Glaucoma Surgery (MIGS) such as Titanium Stents involves making an alternative drainage path for the fluid to escape. This surgery allows for a good long term control of eye pressure and has a good chance of stabilizing the disease without needing invasive open eye surgery such as trabeculectomy.
- Trabeculectomy Surgery involves creating a new pathway for fluid inside the eye to be drained by connecting the anterior chamber and the subconjunctival space. It is a much bigger form of eye surgery as compared to MIGS.
Authored by: Dr Natasha Lim
More than 20 years of experience in Ophthalmology
Internationally renowned pioneer LASIK surgeon for LASIK surgery in Singapore
Education
MBBS (UK)
B.MED. Sci (UK)
MRCOphth (Lond)
FRCOphth (Lond)
Medical Director & Senior Consultant
Ophthalmology
Specialisation
- LASIK
- SILK (Lenticule Extraction)
- LASEK, PRK
- Implantable Contact Lens (ICL)
- Cataract Surgery
- 100% Bladeless Laser Cataract Surgery
- Presbyopia Correction