Ask the expert: Glaucoma

11 March 2019

Ahead of World Glaucoma Week 2019, we caught up with Consultant Ophthalmologist and Glaucoma Specialist, Dr Pankaj Agarwal to find out a few facts and a take-home message about glaucoma.


Glaucoma is caused when there is damage to the optic nerve, caused either by raised eye pressure or weakness in the nerve. 

Glaucoma is the most common cause of irreversible blindness in the world. It's not an uncommon eye condition and the blindness due to glaucoma is irreversible.

Nearly 50% of glaucoma is undetected in the community and in some developing countries, nearly 90% goes undetected.

It is important you attend regular eye checks with your optometrist; this will help with early detection of glaucoma and timely referral to a specialist for treatment. In Scotland, eye tests are free and should not be missed.

The most common type of glaucoma is asymptomatic. Most affected people will only be aware of the condition when it is already in advanced stages.

Don’t wait for eye symptoms to begin, take control of your health and get your eyes tested regularly by the optometrist. The optometrists will advise you regarding the frequency of examination depending upon individual circumstances.

Very effective treatments are available for glaucoma and you can preserve your eye sight. You don’t need to live with the fear of going blind.

Most patients can be very effectively managed by drops only and their glaucoma can be very well controlled.

Use your drops in the proper and correct way, following the dosage as advised by your specialist to have maximum effect.

It is well known that 50% of the diagnosed patients have issues with compliance and may not be able to use drops properly. Check with the specialist doctor or the pharmacist who can advise you on the correct technique.

Lasers can also be used to help reduce the intraocular pressure in some patients, this can help control the glaucoma.

Alternative methods to drops such as Selective Laser Trabeculoplasty (SLT) can also be done as a primary or as an additional treatment to help reduce intraocular pressure. Check with your doctor and they can advise you on this.

Some patients might need surgery if the glaucoma is progressive despite using drops, or if the drops are ineffective or if you are unable to use drops.

Many surgical options are available nowadays such as trabeculectomy and minimally invasive glaucoma surgery; these lower the intraocular pressure safely. Make sure to ask your specialist for further advice.

Are cataract and glaucoma inter-related?

A person with glaucoma can have cataracts and vice versa. Contrary to previous belief, cataract surgery is not an issue for people with glaucoma. In fact most of the time, it can help with the management of glaucoma.

What are the types of glaucoma?

Glaucoma can be classified in various ways but the most common way to classify it is open angle glaucoma and closed angle glaucoma. Open angle glaucoma is the most common form in Caucasian populations.

Is there anything a person with glaucoma can do to help improve the condition?

Yes, a lot of simple lifestyle changes can be made such as healthy eating, stopping smoking, meditation and relaxation exercises etc. Ask a specialist for further advice.   

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