Glaucoma is a common eye condition where the optic nerve - the nerve which connects the eye to the brain - becomes damaged. This damage is usually a result of a fluid buildup in the front section of the eye which in turn leads to increased pressure inside the eye.
Glaucoma most commonly affects adults aged 70 and over; however, glaucoma can occur in patients of any age. If glaucoma is not properly and effectively diagnosed and treated in its early stages, it can lead to vision loss. Glaucoma usually affects both eyes, with the possibility of the condition becoming worse in one eye.
How do I know if I have glaucoma?
Glaucoma is usually symptomless in its infancy. Over the course of years as the condition continues to slowly develop, a patient's peripheral vision (the edges/corners of a patient's vision) is the first symptom to develop as a patient begins to become affected. As this is not 'direct vision' patients often do not realise they have glaucoma and hence do not seek treatment. Usually, glaucoma is only picked up at a patient's routine eye test. Other symptoms of glaucoma can include blurred vision and multi-coloured, rainbow like circles surrounding bright light.
In rare cases, glaucoma can develop much quicker and lead to a wide range of symptoms including the standard blurred vision and rings around lights, as well as other such as red eye, headaches, tenderness in the eye area, nausea/vomiting and intense, severe eye pain.
What are the different types of glaucoma?
There are numerous types of glaucoma, with the most common type of glaucoma being primary open angle glaucoma. Primary open angle glaucoma tends to develop slowly over many years, and is when the fluid drains in the eye begin to become gradually more clogged over time. Aside from this, there is acute angle closure glaucoma -; less common in nature and caused by a sudden blockage of the fluid drains in the eye and a consequent sharp rise in pressure levels within the eye.
People can also be diagnosed with secondary glaucoma which is caused by another underlying eye condition (inflammation for example), and childhood (congenital) glaucoma, which is an extremely rare variant of the condition occurring in young children and often brought on by an abnormality of the eye.
Glaucoma can occur for a number of reasons. The most common cause of glaucoma is the build-up of intraocular pressure in the eye. The nerve which connects the eye to the brain, the optic nerve, becomes damaged as a result of a fluid build-up in the front section of the eye which in turn leads to increased pressure inside the eye. Whilst there is a lack of certainty surrounding why this happens, the prevalence of glaucoma is linked with certain risk factors including age, ethnicity, family history and other medical conditions including short and long-sightedness, as well as diabetes.
While it is also unclear whether anything can be done in preventing glaucoma, regular eye exams are important in recognising it as soon as possible.
There are a number of treatment options available at Eye Care Scotland. We have Glaucoma Specialists at Eye Care Scotland in Glasgow, Stirling, and Aberdeen, meaning wherever you are, there is a glaucoma treatment service near you.*
Selective Laser Trabeculoplasty (SLT)
Selective Laser Trabeculoplasty (SLT) is one treatment option for glaucoma. SLT is a non-surgical form of laser surgery targeted at lowering the intraocular pressure in the eye and hence halting the spread of glaucoma and slowing down the effects of glaucoma considerably.
SLT is recognised as the first-line treatment in treating glaucoma and can be delivered to patients independently, or alternatively alongside eye drops if necessary, to reduce the intraocular pressure in the eye by improving drainage. This procedure takes approximately five minutes per eye and is expected to last around two years or more.
Minimally Invasive Glaucoma Surgery (MIGS) - iStent Inject
Minimally Invasive Glaucoma Surgery (MIGS) is another option available in treating glaucoma. MIGS works by using microscopic-sized equipment and making tiny incisions in the eye. With MIGS, the group of operations can be divided into several categories. These range from trabecular bypass operations and totally internal or suprachoroidal shunts, to miniaturised versions of trabeculotomy and milder, gentler versions of photocoagulation.
Minimally Invasive Glaucoma Surgery (MIGS) can be carried out as an independent treatment for glaucoma; however, it is also a viable treatment option for patients who also plan on undergoing cataract surgery.
MIGS with cataract surgery involves the use of a miniscule device called an iStent Inject. The iStent Inject is a surgical device which is inserted into the eye to lower the pressure in the eye and control glaucoma. The iStent Inject is placed into the eye's drainage system, creating a bypass between the front part of the eye and its natural drainage system to restore the eye's natural ability to drain fluid. The procedure takes approximately five minutes. Interestingly, the iStent Inject is the smallest device which can be put in the human body, measuring one third of a millimetre.
Trabeculectomy Surgery
A trabeculectomy is a surgical operation for treating glaucoma designed to lower intraocular pressure inside the eye when both laser and medical treatments fail. This occurs by making a small hole in the wall of the eye, before going on to drain the eye. This reduces pressure levels on the optic nerve, whilst also slowing down and preventing any further damage and vision loss.
If you suspect you have glaucoma, it is always best to get an expert opinion. At Eye Care Scotland, we recommend booking a consultation with one of our experienced glaucoma consultants who can help you with both your diagnosis and ongoing glaucoma treatment.
*Certain glaucoma treatments are only available at Eye Care Scotland, Glasgow, located at Ross Hall Clinic Braehead. If patient requires glaucoma treatment unavailable at their chosen Eye Care Scotland location, they can be referred to Eye Care Scotland, Glasgow.
Omni Surgical System
The Omni® Surgical System is a truly unique approach to the treatment of glaucoma. This is an implant-free procedure, setting it apart from most other MIGS. Removing as many blockages caused by the specialised tissue as possible, the Omni® is designed to relieve the pressure buildup in the eye by enabling fluid to drain more easily. The Omni® enlarges the drainage canal before delivering a unique, and importantly safe, fluid called viscoelastic which clears the channel in the eye. With a reduced resistance to fluid leaving the eye, the pressure reduces on the optic nerve.
The Omni® has the capability to reduce or even eliminate the need for drops, and can be carried out at the same time as cataract surgery. The treatment is for those with open-angle glaucoma, whether it be mild, moderate or severe.
Hydrus Microstent
The Hydrus Microstent is a miniscule (roughly the size of an eyelash) curved device that is inserted into the Schlemm’s canal. Upon insertion, the Hydrus Microstent has the ability to dilate the canal by four to five times its natural width. This counters the collapse of the Schlemm’s canal which is induced by elevated intraocular pressure.
The device is designed to be implanted in patients undergoing glaucoma surgery in conjunction with cataract surgery, reducing the intraocular pressure in adults with mild to moderate primary open-angle glaucoma.
Preserflo MicroShunt
The Preserflo MicroShunt is a minute tube (8mm long) which is inserted into the eye to help lower the intraocular pressure and reduce reliance on medication. The aim of the device is twofold – to reduce pressure in the eye, and subsequently slow down any further damage to the optic nerve.
The device works in a similar manner to Trabeculectomy surgery – the more traditional means of glaucoma surgery – by draining fluid from the inside of the eye to the outside under the conjunctiva. The fluid being drained is pooled under the conjunctiva to form a ‘bleb.’ This bleb remains as long as the fluid drains.
At your initial consultation with us at Eye Care Scotland, our Glaucoma Specialist will discuss with you a range of diagnostic tests and scans that we can carry out. These include:
- Visual acuity test
- Intraocular pressure check
- Visual field test
- Optic disc photography
After these tests and scans are complete, our Glaucoma Specialist will then outline a personalised patient pathway plan for you, discussing your options regarding glaucoma treatment - glaucoma medications, glaucoma management, and glaucoma surgery. Each option will be presented and explained in depth in coming to the most appropriate glaucoma treatment plan for you.
Recovery times after glaucoma treatment and glaucoma surgery vary depending on the patient and other mitigating circumstances. Whilst our Glaucoma Specialist will be able to outline this in more detail, below is a summary:
Selective Laser Trabeculoplasty (SLT) Glaucoma Treatment Recovery Time
SLT is an outpatient procedure, meaning patients are usually allowed to return home the same day as their glaucoma treatment. With SLT, the full effects of this glaucoma treatment can take up to 3 months. Patients can expect common symptoms such as blurred vision to last up to 24 hours, whilst others such as slight irritation to last for up to 48 hours. It is important that patients continue to take their prescribed glaucoma medications as well as any other prescribed eye drops.
Patients will require a follow-up appointment after their SLT glaucoma treatment to properly gauge the intraocular pressure and check-up on any symptoms the patient may be experiencing.
The effects of SLT can last anywhere between 2-5 years in patients. Crucially, SLT as a glaucoma treatment can be repeated.
iStent Inject Minimally Invasive Glaucoma Surgery (MIGS) Recovery Time
iStent Inject MIGS is a day case procedure, meaning patients are usually allowed to return home the same day as their glaucoma surgery. Patients will be prescribed antibiotic and anti-inflammatory eye drops to use after their surgery.
Patients will require two follow-up appointments after their glaucoma surgery; one day post-op and one month post-op.
After glaucoma surgery, patients may be recommended to take a few days off from work and refrain from strenuous activities. The recovery time after this glaucoma surgery is generally rapid, allowing patients a quick return to normal activities.
Trabeculectomy Glaucoma Surgery Recovery Time
Trabeculectomy glaucoma surgery is a day case procedure, meaning patients are usually allowed to return home the same day as their surgery.
Patients will require continuous follow-up care with their Consultant Ophthalmologist after their glaucoma surgery.
There are a number of steps prescribed in the aftercare for this glaucoma surgery. Patients may be required to take steroid eyedrops for healing and to prevent scarring, cover their eye with a shield when sleeping, avoid rubbing the eye, and avoid heavy lifting, straining, and vigorous exercise. It can take anywhere between two to six weeks for a patient's eye to properly recover from this glaucoma surgery.
The glaucoma treatment cost is dependent on a number of factors. Prices are from:
- Selective Laser Trabeculoplasty (SLT) - £853.50*
- Selective Laser Trabeculoplasty (SLT) (Bilateral) - £1,281.50*
- iStent Inject - £4,695*
- iStent Inject with Cataract Surgery - £6,487*
We also offer flexible finance through our dedicated finance provider, Chrysalis Finance. Patients have the ability to spread the cost of their treatment over up to 5 years. If patients choose to spread the cost over 10 months, then these payments will be interest free. Should patients choose to pay over a longer period, 14.9% APR will apply. To find out more about our flexible finance, please visit here.
*All prices are per eye and are based on treatment under local anaesthetic. These are just guide prices and will differ from person to person because our treatment packages are all personalised. For more information, give us a call.
Our consultants are supported by a full clinical team of optometrists, orthoptists, ophthalmic nurses and ophthalmic practitioners - all of whom play a vital part in ensuring patients are well informed and cared for throughout their journey.
Our entire patient pathway takes place within a clinical environment, and we work to the highest standard of governance whilst following stringent processes to ensure quality outcomes for patients.
With enhanced patient pathways and streamlined consultation-to-treatment journeys at the heart of Eye Care Scotland, you can be confident in receiving the highest levels of care throughout your whole journey with us - from diagnoses to treatment and right through to your recovery.
Content reviewed by Circle in-house team in September 2022. Next review due September 2025.
