How many people are affected?

With an estimated 4.5 million affected globally, glaucoma is the second most common cause of blindness worldwide and it is estimated that this figure will rise to 11.2 million by 2020.

In the UK, it’s estimated that more than 500,000 people have the illness with many more undiagnosed.

Types of glaucoma

Glaucoma develops slowly, causing gradual damage to the optic nerve, often without any early warning signs or symptoms, and it can be years before there is any noticeable vision loss. Therefore, by the time you notice that your vision is reduced the disease process is usually quite advanced.

In recognition of the seriousness of the disease the National Institute for Health and Care Excellence (NICE) implemented guidelines to give clear recommendations on testing for, and diagnosing, glaucoma, and on effective monitoring and treatment to prevent these conditions progressing. The aim of the guidelines is to prevent more people from going blind.

There are four main types of glaucoma:

• Primary open angle glaucoma (POAG); also known as chronic glaucoma. This is the most common type of glaucoma and develops very slowly.
• Acute angle closure glaucoma. This is rare and can occur slowly (chronic) or may develop rapidly (acute) with a sudden, painful build-up of pressure in the eye.
• Secondary glaucoma. This mainly occurs as a result of an eye injury or another eye condition, such as uveitis (inflammation of the middle layer of the eye).
• Developmental glaucoma. A rare but sometimes serious type of glaucoma which occurs in very young children, caused by an abnormality of the eye

Find out more about glaucoma on the NHS web pages.

The damage caused by glaucoma is permanent. It cannot be reversed, even with surgery. But if it is diagnosed and treated early enough, further damage to vision can be prevented.

Signs to look out for

Unfortunately, most cases of glaucoma do not have any immediately noticeable symptoms, but the presence of some of the warning signs listed below would suggest that you should see an optometrist for routine sight testing. Or see your GP:

• Unusual trouble adjusting to dark rooms
• Difficulty focusing on near or distant objects
• Squinting or blinking due to unusual sensitivity to light or glare
• Change in color of iris
• Red-rimmed, encrusted or swollen lids
• Recurrent pain in or around eyes
• Double vision
• Dark spot at the center of viewing
• Lines and edges appear distorted or wavy
• Excess tearing or “watery eyes”
• Dry eyes with itching or burning; and
• Seeing spots or ghost-like images

If you experience any of the following you should seek urgent medical help:

• Sudden loss of vision in one eye
• Sudden hazy or blurred vision
• Flashes of light or black spots
• Halos or rainbows around light

The symptoms listed above DO NOT mean that you have glaucoma but if you do experience one or more then see an optometrist (or your GP) for a complete eye exam.  They will then refer you to the appropriate specialist if necessary.

In most cases, although the damage cannot be reversed, if caught in time, glaucoma can be treated and the disease progression stabilised with medication in the form of eye drops.  Lifelong monitoring will be needed so that any progression of visual damage can be detected. In some cases surgery may be required.

Who is at risk of developing glaucoma?

It must be stressed that everyone is at risk of developing glaucoma, and therefore everyone should be aware of the risks, although certain groups are at higher risk than others.

The most important risk factors include:

• Age: it is much more common among older people. You are six times more likely to get glaucoma if you are over 60 years old.
• High Intraocular Pressure (IOP) : high eye pressure alone does not mean that you have glaucoma, but it is an important risk factor for developing the disease.
• African ancestry: glaucoma is 4 times more common in people with African ancestry than in Europeans.
• Thin cornea.
• Family history of glaucoma: the most common type of glaucoma, primary open-angle glaucoma, is hereditary.
• Nearsightedness.
• Past injuries to the eyes: this type of glaucoma can occur immediately after the injury or even years later, and the most common cause is sports-related injuries such as baseball or boxing.
• Steroid use: there are studies which link this to glaucoma.
• A history of severe anemia or shock.
• Hypertension.
• Diabetes.

Preventing glaucoma

Approximately 2% of people over the age of 40 in Britain have glaucoma –  the most common form of which is chronic open angle glaucoma (COAG), therefore:

• If you are under 40 you should have a comprehensive eye examination every three to four years.
• If you are under 40 with one of the above risk factors you should get tested every one and a half to two years.
• If you are 40 years or older you should have a comprehensive eye examination every one and a half to two years.
• If you are 40 and have an additional risk factor listed above, get tested annually.
• Everyone with high risk factors should be tested every year or two after 35.

If you are over 40 years old and have a first-degree relative (mother, father, sister or brother) with glaucoma they you are entitled to a free NHS eye test.

You may also be entitled to a free NHS eye test if:

• An ophthalmologist thinks you are at risk of developing glaucoma.
• You are over 60 years old.

Find out about further NHS optical services.

How can Graysons help?

As the Royal College of Ophthalmologists points out, “there have been a number of well-publicised cases in Britain where pressures on ophthalmology services have led to patients with glaucoma being lost to follow up or having their appointments repeatedly rescheduled, and the consequence has been avoidable deterioration in vision in some patients”.

Here at Graysons we recognise the devastating effect that a delayed diagnosis of glaucoma can have. We understand the importance of compensation to you as it can greatly improve quality of life for you and your family and provide the care and security that is needed.

If you would like to talk to a member of our specialist medical negligence team then please contact us for a confidential and free discussion today.

You can find out more about claiming compensation for medical negligence on our web pages.

Find out more about World Glaucoma Week.