Glaucoma

Glaucoma is a condition which can gradually start to interfere with the vision, usually starting in the edges (peripheral vision).  If it is picked up early, treatment will usually keep the vision good.   Further information about glaucoma is available from the International Glaucoma Association .

The glaucoma service is run by two consultants, Mr Tom Eke and Mr Nuwan Niyadurupola. They have clinics at the Norfolk & Norwich University Hospital and also at Cromer Hospital.  Most of the people who come to the glaucoma service are referred by their optometrist.   Your optician (optometrist) may do a check for glaucoma, as part of a routine eye check.

What happens in glaucoma clinics?

A typical visit to the glaucoma clinic will involve the following.   A nurse will measure your vision on the eye chart, and ask some questions about your eyes and general health.   We usually assess the peripheral vision using a machine called an automated perimeter (Visual Field test ).   Your optometrist may have already done a very similar test.   You sit in front a screen, and some dim lights go on and off, and you need to press a button each time you see a light.   Your eyes will then be examined by one of the eye specialists in the clinic.  We will probably use eye-drops that can blur the vision for a few hours, so you should not drive yourself home from clinic.

If glaucoma is confirmed, we may prescribe some eye drops to put in every day.  Generally speaking, the eye drops would not make the vision any better, they are used to prevent the vision getting worse in the future.   People with glaucoma will need to put their eye drops in every day, and come back for checks, as suggested by specialists in the clinic.

Many patients who come to the clinic are found to be “border line”, but do not need to be on any glaucoma treatment.  Some of these people will be sent back to their optometrist for regular checks, and others will stay under review with the glaucoma service, depending on how things look.

Other Treatments for Glaucoma

For some people who have glaucoma, the eye drops do not work well enough.   There are other options available, either operations or laser treatments (including laser iridotomy ).   Our most commonly performed operation is called trabeculectomy , though in some patients a cataract operation can help with the control of glaucoma.

Other treatments on offer include cyclodiode laser , laser trabeculoplasty, and glaucoma drainage implants.   Sometimes we will suggest treatments to improve the blood circulation at the back of the eye.

Each patient is assessed individually, to decide the optimum treatment for their particular case.

Research

The department is active in research, with several publications in scientific journals each year.  There is a close link with the University of East Anglia.  Research subjects include the pathogenesis of glaucoma, effectiveness of glaucoma treatments, visual outcomes, new techniques, and patient satisfaction.  See our pages regarding Eye department Research & Publications .   Click the link for an update on many of our glaucoma research projects .

Driving and Glaucoma

If you had drops to dilate the pupil then your vision will be blurred. It usually takes 2-4 hours, but can take up to 24 hours for the drops to wear off. Therefore, we advise that you do not drive yourself home from the eye clinic.  If you had other drops, then it should not affect your driving vision.

If you are coming to department for the first time, then your pupil will be most likely to be dilated.  For follow-up checks, we may not need to dilate the pupil every time.

Some eye conditions can affect your ability to drive.  Most people who have glaucoma will need to inform the DVLA (Driver & Vehicle Licensing Agency) about their glaucoma.  the DVLA will usually arrange for you to have a special ‘field of vision’ test, to check whether the peripheral vision is satisfactory.  Please see the DVLA website for current advice: information is also available on the direct.gov website .  Please note that it is your personal duty to inform the DVLA, if you have an eye problem that might affect driving.   Also, you will need to inform the company that does your insurance for driving about any eye condition.

Further Information

Further information on glaucoma is available from the International Glaucoma Association  and the Royal National Institute for the Blind .   If you have any specific questions related to your glaucoma, feel free to ask when you come to the clinic.