QUESTIONS ABOUT GLAUCOMA
We know there are a lot of questions to be asked about glaucoma. We’ve gathered some of the most common ones we receive from Glaucoma NZ members and answered them here. Have another question? Contact us here.
I am a 37 year old male who does not know a lot about his biological history. Do I need to be tested for glaucoma, how much is it likely to cost, and where would I go to get tested?
We recommend that everyone should have a glaucoma test at the age of 45 and every 5 years after that. Often, people with a known family history of glaucoma will go sooner. Considering you don’t know your family history, it would be wise to have an eye health check with an optometrist now. After an initial check, your optometrist can advise how often to get repeat checks. The cost of checks varies – it might be a good idea to ring around to get an idea of prices.
Why does Glaucoma NZ recommend eye examinations only every five years from age 45? I have read other recommendations suggesting every two years.
Glaucoma screening is a complex matter – it’s never a case of ‘one size fits all’. We think we’ve set a realistic and achievable target with the ‘45 plus 5 glaucoma eye examination’. If everyone had an eye examination every five years between 45 and 60, people at higher risk of glaucoma would be identified and monitored more closely and an earlier diagnosis of glaucoma would be possible.
Glaucoma NZ places emphasis on understanding and assessing the risk factors of glaucoma when you have an eye examination. At your first eye check, your eye health professional will be able to assess your level of risk – such as the state of the optic disc, the shape of the angle, and the level of intraocular pressure – and establish how often you need to be examined.
What is an ophthalmologist?
Sometimes also referred to as eye specialists or ophthalmic surgeons, ophthalmologists are specialist medical practitioners. It’s a serious profession, and takes a minimum of 14 years of training to become one. To train as an eye surgeon, a doctor becomes a registrar in a hospital and a trainee of the Royal Australian and New Zealand College of Ophthalmologists for a period of five years. After passing exams, a New Zealand trainee will go abroad for a few years to gain further experience in overseas centres where the caseloads and expertise differ to New Zealand.
What is an optometrist?
Optometry is a university degree course of 5 years. During their studies, modern optometrists are taught how to diagnose and screen for common eye diseases, including glaucoma and diabetic eye disease. They prescribe and dispense glasses and contact lenses, and are often the first port of call for those with eye problems.
My mother is sure she heard on talkback radio that there is a cure for glaucoma. Is this correct?
Unfortunately, at the moment there is no cure for glaucoma – damage to the optic nerve can’t be repaired. Glaucoma treatment is instead focused on preventing any further damage and sight loss. Your mother might have heard discussion about advances in the treatment of another eye condition, like macular degeneration.
Why are eye drops used in glaucoma?
The answer is to help prevent the loss of vision from glaucoma. The exact cause of glaucoma is not known, but we know age, family history and raised pressure in the eyes (intraocular pressure) are risk factors. Of these, only the eye pressure is modifiable, and lowering it slows the loss of peripheral, and then central, vision in glaucoma. Eye drops are the commonest and preferred way of achieving this.
Why do I have to use my eye drops permanently and continually?
In order to prevent visual loss, the pressure must be constantly controlled. The effect of each dose of drops lasts for only a limited time. If a drop is given four times a day, it is because the effect of the drop only lasts about 6 hours. If the drops are not continuously used the pressure will creep back up again.
Do I have to get up at night to take my eye drops?
No. An undisturbed night is more important, but if prescribed for use three or more times daily, it is usually desirable to put them in last thing at night and as soon as you wake up in the morning.
Are my eye drops supposed to sting when I put them in?
All drops may cause some burning or stinging when instilled. Often, this effect is due not to the drug but to the antibacterial preservatives in the solution. It is rarely intolerable and can be used to advantage, since it lets the patient know that the drop got into the eye. If you are experiencing a lot of discomfort you should report this to your eye specialist, as there may be different options for you.
If I have two lots of drops due at the same time, can I put them in together?
It is probably best to allow five to ten minutes between drops to avoid one drop washing out the previous one. Ask your eye specialist for specific advice about the drops you are taking.
Do I need to put the drops in before I come to the clinic?
Yes. Always continue as usual unless requested otherwise. It helps the doctor to judge the effect of the treatment.
Does it matter if I put more drops into my eye than I should?
No, not usually. But your doctor will have prescribed you the optimal dosage for the medication you are using. If you are unsure whether the drops actually get in your eye, it may be useful to keep the drops in the refrigerator. You should feel the ‘cold’ of the drops and can be sure they have gone in.
How important is it to put the drops in at exactly the time stated?
It is obviously better to keep to the correct times, but sometimes circumstances make this difficult. In most circumstances, as long as you get the drops in within a few hours on either side of what you normally do, no harm will come. If you forget to put your drops in, put them in as soon as you remember and do not worry about it unduly. Nevertheless, make a determined effort to use them regularly and without fail.
Can I take other medicines at the same time as my glaucoma treatment?
Patients with certain types of glaucoma should have advice before taking some types of medications. Always mention to both your general practitioner and your eye specialist all the medications that you are taking and your doctor will advise you.
I have to go into hospital next month for an operation. Do I need to take my eye drops with me or can I give them a break for a while?
It’s very important to take your glaucoma medications with you and to continue with your glaucoma treatment. Make sure your doctors are informed that you take glaucoma medication. You can use your Glaucoma NZ ID card to record your ophthalmologist’s name and the details of your medication. Sometimes glaucoma treatment gets overlooked because attention is being given to your other problems. Remind nursing staff if you think your drops have been forgotten.
What should one do if one forgets to pack one’s eye drops on a trip overseas?
The short answer to this one is don’t do it! Don’t ever jeopardise your sight by going away without your drops! The Glaucoma NZ ID card has space for recording details of your medication and treatments as well as the phone numbers of your eye health professionals in New Zealand. If you carry that in your wallet you will have information at hand if you need to seek a replacement prescription while overseas. Another good idea is to carry a brief summary letter from your ophthalmologist with you when you travel overseas. If you are a frequent traveller why not keep such a letter with your passport, so it travels with you. Who knows, seeing the letter might even serve to remind you to check that your drops are packed before you go.
I am finding it difficult to manage my eye drop bottle. Is there anything available to help me?
There are some devices to help you get your drops in. They are generally available from your eye specialist or some can be ordered on our website here .
I have had glaucoma for many years and now it seems I am developing cataracts. Can I have cataract surgery if I have glaucoma?
Yes, you can still have a successful cataract surgery if you have glaucoma. While your eye pressure may be temporarily elevated after surgery, your eye surgeon will monitor it carefully. In the long term, some patients even experience a reduction in intraocular pressure following cataract surgery.
Causes of glaucoma