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Glaucoma Screening and Management
Glaucoma is due to elevated intra-ocular pressure (IOP) or elevated pressure inside the eyeball. Prolonged elevated IOP leads to damage of the optic nerve and a constriction of the visual field.
In primary open angle glaucoma (most common form), the damage is slowly progressive and the patient may not notice any symptoms until advanced loss has occurred. The risk factors include advancing age and a positive family history. It is therefore important for those with a positive family history to be screened for the condition. The mainstays of treatment include medication (eye drops), laser (trabeculoplasty) or conventional filtering surgery (trabeculectomy).
In Singapore, a less common form of glaucoma called acute narrow angle glaucoma typically affects the elderly Chinese population. Unlike the more common form, acute narrow angle glaucoma presents suddenly and with significant symptoms of pain, redness, loss of vision, headache and seeing ‘haloes’.
In this instance, a sudden rise in eye pressure occurs in a predisposed eye leading to severe symptoms and immediate medical treatment is necessary to reduce the risk of severe visual loss.
In general, long sighted or hyperopic eyes with narrow angles are at risk of acute angle glaucoma. Acute narrow angle closure may be prevented by performing a prophylactic laser peripheral iridotomy in ‘at risk’ eyes. In general, people with a family history of any form of glaucoma should undergo regular screening with their ophthalmologist.
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