Glaucoma: The eye condition which can cause vision loss that only half of Kiwi sufferers know they have

Ahead of World Glaucoma Awareness Week, we talk to an expert about the myths surrounding the eye disease that affects up to 115,000 Kiwis and what you can do to prevent unnecessary vision loss as you age.

By Now To Love with Glaukos
For those of us lucky enough to be born with vision in both our eyes it's all too easy to take our sight for granted. It can be difficult to imagine life without your sight, however as we age, so do our eyes and it becomes increasingly likely that our vision will begin to deteriorate, potentially causing vision loss, dry eyes and glaucoma.
That's why, when we reach our forties and beyond it becomes increasingly important to get regular eye checks to ensure any potential issues are detected early. Eye diseases like glaucoma – a condition which causes damage to the eye's optic nerve can lead to permanent loss of sight before any physical symptoms are even noticed.
It's estimated that a shocking 115,000 Kiwis over 40 years old have glaucoma, but only half of them know it. This means more than 50,000 New Zealanders could be heading for unnecessary loss of eyesight – that's more than the population of Nelson.
While there is currently no cure for glaucoma there are a range of effective treatments options that will prevent further visual impairment.
Ahead of World Glaucoma Awareness Week from March 8 to 14, we spoke to Auckland-based Ophthalmologist Divya Perumal who specialises in glaucoma and cataract surgery. She busts some of the common myths surrounding glaucoma and explains what we can do to help protect our vision as we age.

Common myths about glaucoma

1. If you have excellent vision you will not get glaucoma
Ophthalmologist Divya Perumal says glaucoma can affect anyone, even if you have excellent vision.
2. Glaucoma is a condition that only affects older patients
While glaucoma is more commonly seen among patients over 40, Perumal says glaucoma can affect people of all ages, including babies.
3. Glaucoma is an inherited condition and one is not at risk if there's no family history of glaucoma
Perumal says many patients are diagnosed with glaucoma despite having no family history of the disease.
4. Glaucoma leads to blindness
If diagnosed early enough, most patients will not go blind if they are compliant with treatment guidelines. Eye drops are usually prescribed in the first instance. Some patients may be able to take advantage of new MIGS (Minimally Invasive Glaucoma Surgery) technology such as the Glaukos iStent inject Trabecular Micro-Pass System, which may stop the progression of glaucoma in some patients when detected early.

What are some of the first signs of glaucoma and how does it affect those who have it?

Perumal says often there are no early signs of glaucoma.
"Patients don't always experience the classically referred to 'tunnel vision'," Perumal explains.
"Studies have indicated the most common symptoms are patients missing parts of their vision and experiencing a 'jack in the box' phenomenon, where a feature in their vision comes in and out of their 'blind spot'.
"For example, if you're driving and a child is playing by the side of the road a glaucoma patient may not see the child while driving towards them, and then, only suddenly notice the child as they drive past them."
Perumal says other symptoms can (but not always) include headaches, seeing halos around lights, nausea and vomiting.
While sometimes there are no early signs of glaucoma, some patients may experience headaches, seeing halos around lights, nausea and vomiting.

Are some people more at risk of developing glaucoma than others?

A family history of glaucoma can increase your risk of developing the condition Perumal says and she recommends all family members of patients with glaucoma to have regular eye checks at their optometrists.
"There are also individuals who may be at greater risks of specific subsets of glaucoma and therefore we cannot emphasise enough the importance of regular eye checks to detect and control the disease early."

How can people prevent or manage glaucoma?

The best way to detect and control glaucoma is by having regular eye checks.
Glaucoma New Zealand recommends that everyone has a glaucoma examination by the age of 45 then every 5 years after that until 60, and three-yearly after that. Those with risk factors for glaucoma such as a family history of glaucoma or steroid use should be examined earlier.
At your examinations, your optometrist will carry out eye pressure and peripheral vision tests, as well as optic nerve thickness measurements as part of your regular eye exam.
Perumal explains there is currently no cure for glaucoma however when diagnosed early, there is a range of effective treatment options that will prevent further visual impairment.
The only clinically proven treatment is to lower eye pressure says Perumal.
"Eye drops have traditionally been the standard treatment for glaucoma, but we know that many patients find them difficult to administer on a daily basis, or are concerned about the side effects.
"My key advice would be to meet with your glaucoma practitioner and speak about your concerns early. We will always endeavour to find the best solution for our patients, and if conventional treatments fail, surgery can be very effective in managing glaucoma."
While eye drops have traditionally been the standard treatment for glaucoma, new technology is providing a simple and effective treatment in the form of the smallest medical device known to be implanted in the human body.
Perumal says a new introduction to glaucoma surgery in New Zealand, the Glaukos iStent inject, is also available to some patients to stop the progression of glaucoma.
"The Glaukos iStent inject is the smallest medical device known to be implanted into the human body, about the size of a speck of dust, and it involves a short, simple procedure with minimal recovery time," says Perumal.
"Most of my patients are very pleased with the results following having their iStent inject inserted and it is great to have another treatment option in the management of early to moderate glaucoma."
Patients with glaucoma should talk about their treatment options with their Ophthalmologist and then their insurance providers to consider what is the best treatment option for them. The Glaukos iStent inject is currently funded by healthcare insurers NIB, Sovereign, Accuro and Partners Life.