Glaucoma

At Toowoomba Ophthalmic Consultants we are the only practice in Toowoomba to use the Heidelberg Spectralis OCT to examine the retinal nerve fiber layer thickness around the optic nerve with high resolution optic nerve head images and analysis.

Glaucoma is the name given to a group of eye diseases that, if left untreated, result in progressive damage to the retinal cells that form the optic nerve. The result is a damaged optic nerve, and progressive loss of peripheral vision. The significant problem with glaucomatous peripheral vision loss is that it is not detectable by the patient, so they are unaware they have the disease and are losing vision. What is worse is that the vision loss associated with glaucoma is permanent so prevention is the absolute key. According to Glaucoma Australia, 50% of patients with glaucoma are undiagnosed. In Australia, 2 – 3% of the total population develop glaucoma, but if you have a first degree relative with glaucoma then your risk of developing glaucoma increases to almost 1 in 4.

Image

Technology to precisely measure retinal thickness in glaucoma

Image

Precise laser scanning measurements allow any glaucoma progression to be detected early and treatment adjusted

Glaucoma investigations


Detection of glaucoma requires a careful clinical assessment. A combination or all of the following tests may be used to make an assessment of your eye health with respect to glaucoma:

  • tonometry – measurement of intraocular pressure
  • pachymetry – measurement of corneal thickness which can influence intraocular pressure readings
  • gonioscopy – to assist in determining which type of glaucoma you may have
  • stereoscopic optic nerve head examination and photos
  • OCT analysis of retinal nerve fiber layer thickness
  • visual field assessment using a computerised perimeter
Measurement of the retinal nerve fiber layer in suspected glaucoma patients helps detect glaucomatous changes prior to those evident on visual fields and hence treatment may be recommended sooner than would otherwise be possible. Toowoomba Ophthalmic Consultants uses the Heidelberg OCT to measure and track retinal nerve fiber layer thickness in glaucoma.

Whilst the exact mechanisms of the disease are still being established, intraocular pressure is a primary risk factor and its lowering forms the mainstay of glaucoma treatment. Intraocular pressure may be lowered in a number of ways:

  • eye drop medication
  • selective laser trabeculoplasty
  • MIGS (minimally invasive glaucoma surgery) devices
  • traditional glaucoma surgery

Image

Spectralis OCT: State-of-the-art imaging technology used in our Toowoomba clinic

Minimally Invasive Glaucoma Surgery (MIGS)


Dr Holcombe performs minimally invasive glaucoma surgery. This is a relatively new type of surgical procedure available to glaucoma patients that offers them the opportunity to reduce their glaucoma eye drop use or occasionally cease them entirely. At the time of cataract surgery, a small drainage device is inserted into the drainage apparatus of the eye. This enhances drainage from the eye, reducing its pressure. Following this procedure many patients can reduce the number of glaucoma drops they require and occasionally may cease them all together.

Image

A microscopic trans-trabecular drainage stent used in glaucoma management

At your glaucoma appointment Dr Holcombe will discuss what options are available to you for glaucoma management.

Contact Toowoomba Ophthalmic Consultants today  

20 Goggs Street
Toowoomba QLD 4350

20 Goggs Street
Toowoomba QLD 4350

Glaucoma

At Toowoomba Ophthalmic Consultants we are the only practice in Toowoomba to use the Heidelberg Spectralis OCT to examine the retinal nerve fiber layer thickness around the optic nerve with high resolution optic nerve head images and analysis.

Glaucoma is the name given to a group of eye diseases that, if left untreated, result in progressive damage to the retinal cells that form the optic nerve. The result is a damaged optic nerve, and progressive loss of peripheral vision. The significant problem with glaucomatous peripheral vision loss is that it is not detectable by the patient, so they are unaware they have the disease and are losing vision. What is worse is that the vision loss associated with glaucoma is permanent so prevention is the absolute key. According to glaucoma Australia, 50% of patients with glaucoma are undiagnosed. In Australia 2 – 3% of the total population develop glaucoma, but if you have a first degree relative with glaucoma then your risk of developing glaucoma increases to almost 1 in 4.

Detection of glaucoma requires a careful clinical assessment. A combination or all the following tests may be used to make an assessment of your potential glaucoma:
tonometry – measurement of intraocular pressure
pachymetry – measurement of corneal thickness which can influence intraocular pressure readings
gonioscopy – to assist in determining which type of glaucoma you may have
stereoscopic optic nerve head examination and photos
OCT analysis of retinal nerve fiber layer thickness
visual field assessment using a computerised perimeter

Loss of retinal nerve fiber layers are able to detect glaucomatous damage before changes are seen on visual fields and hence treatment may be recommended sooner than would otherwise be possible.

Whilst the exact mechanisms of the disease are still being established, intraocular pressure is a primary risk factor and its lowering forms the mainstay of glaucoma treatment. Intraocular pressure may be lowered in a number of ways:
eye drop medication
selective laser trabeculoplasty
MIGS (minimally invasive glaucoma surgery) devices
traditional glaucoma surgery

All surgical procedures carry some risk. The information provided here is for general educational purposes only. Please contact Dr David Holcombe of Toowoomba Ophthalmic Consultants to discuss the options that are appropriate for your individual situation.