With two million people missing a routine eye test during lockdown, serious and irreversible eye conditions such as glaucoma have gone undetected warns Alastair Lockwood, ophthalmologist and eye health specialist at Feel Good Contacts. In the lead up to Glaucoma Awareness Week (28th June -4th July 2021), Dr Lockwood explains who is most at risk of developing glaucoma (known as a silent killer of vision as patients have few symptoms as the disease progresses) and how to minimise the risks of developing it in later life.

What is glaucoma?

Glaucoma is one of the most common causes of irreversible blindness. It is where the optic nerve (the electrical cable that carries information from your eye to your brain) degenerates more quickly than it should, usually because the pressure within the eye is too high.

Our brains are able to compensate for the natural degeneration so we have little awareness of disease progression however this means there are often no symptoms until the disease is very advanced, and we cannot (yet!) rejuvenate a human optic nerve.

Why does it happen?

There are different reasons why the eye pressure can increase, indeed we do need eye pressure otherwise our eyes would collapse like a balloon with no air in. There is therefore a continuous circulation of fluid inside the eye, and pressure rise is usually gradual and caused by increased resistance of drainage of fluid from the eye into the bloodstream.

More rarely, the eye pressure can rise because the lens inside the eye runs out of space (the lens is one of the few things that continues growing throughout our life like our hair and nails). If this happens then the pressure rise can be very abrupt, high and painful – acute angle closure glaucoma.

Are there any symptoms?

It’s important to note that a lot of people who suffer from glaucoma don’t experience any symptoms early on, which is why regular eye checks are so important. The general recommendation is to visit your optician at least every two years for an examination for a full health check with prescription review, and at least yearly if there are added risk factors, for example a family history.

In acute angle closure glaucoma the abrupt rise in eye pressure may cause pain, particularly in bright lights, headache, nausea and vomiting as well as vision loss.

What can influence your chances of getting glaucoma?

Unfortunately, there is little that one can do to reduce the risk of developing glaucoma. Having a balanced diet, engaging in regular exercise, and not smoking will reduce the risk of other diseases of the optic nerve.

However, you are more at risk of the disease if you have the following:

Have a family history of glaucoma
Are over 40 years of age
Are short-sighted or long-sighted
Hypertension
High blood pressure
Diabetes

Prioritise your eye health

Across most medical specialties, doctors have noted a sharp drop in care during the pandemic, as non essential visits and procedures were curbed and people feared a medical appointment could lead to coronavirus infection.

But it wasn’t just the more dramatic specialities where medical professionals witnessed the collateral damage from Covid. The field of eye health has been hit particularly hard because the decision to skip or delay tests/treatment rarely results in a life-or-death type of scenario. But it can certainly lead to permanent vision damage or even blindness. So I am urging patients not to neglect their eye health. The key to avoiding glaucoma progression is to have regular eye checks which crucially include eye pressure measurement, optic nerve examination and a field test (the ability to see things out of the corner of your eye).