Glaucoma
Glaucoma damages the nerve that carries sight from the eye to the brain. It usually does it slowly, and without pain.
Why glaucoma matters
Glaucoma is a group of conditions that damage the optic nerve, the cable that carries what you see to your brain. In most people it is linked to the pressure inside the eye being too high for that particular nerve.
The damage is slow and painless, and it takes your side vision first. People do not notice it, because the other eye fills in the gap. By the time sight is obviously missing, a great deal of nerve has already gone.
Sight lost to glaucoma does not come back. That is the whole reason for treating it early. What treatment does is stop it getting worse.
Who should be checked
- Anyone with a parent, brother or sister who has glaucoma.
- Anyone over about 40, as part of a routine eye test.
- Anyone told by an optometrist that their eye pressure is raised or their optic nerve looks unusual.
A check is straightforward and does not hurt.
How it is found and followed
Diagnosing glaucoma is not a single test. It usually means measuring the pressure in the eye, examining the optic nerve, checking the drainage angle, and mapping your side vision. Those tests are then repeated over time, because what matters most is whether anything is changing.
This is why glaucoma patients are seen regularly for years. The appointments are not a formality.
How it is treated
Treatment aims to bring the pressure down to a level that particular nerve can tolerate. In broad terms there are three approaches, often used in that order:
- Drops. Used every day, usually for life. They work well as long as they are actually used, which is the hard part.
- Laser. Done in the rooms, and can reduce or delay the need for drops.
- Surgery. Considered when the pressure stays too high, or the damage keeps progressing, despite the above.
Viscocanalostomy
Dr Patel performs viscocanalostomy, a form of glaucoma surgery that few surgeons in South Africa offer.
The usual glaucoma operation, trabeculectomy, makes a full-thickness hole through the wall of the eye so that fluid can escape. It works, but it leaves a bleb: a small blister of fluid under the upper eyelid. Blebs can leak, become infected, or cause discomfort, sometimes years afterwards.
Viscocanalostomy takes a different route. Instead of cutting a hole, the surgeon opens and widens the eye's own natural drainage channel so that fluid leaves the way it was always meant to. Nothing is cut all the way through, and there is no bleb.
It is technically demanding, which is why it is not widely offered. The technique was developed in South Africa by Professor Robert Stegmann.
Dr Patel continues to develop the procedure and teaches it to other surgeons, in South Africa and abroad, including hands-on teaching in other centres.
Is it right for everyone?
No. It suits some kinds of glaucoma and not others, and the decision depends on the type of glaucoma, how far it has gone, and what the eye's drainage angle looks like. Some eyes do better with a trabeculectomy, and Dr Patel will say so if that is the case.
If you have been told you need glaucoma surgery and you would like to know whether this operation is an option for you, phone the rooms and arrange to be seen.
Children and glaucoma
Glaucoma in childhood is uncommon and quite different from the adult condition. Dr Patel sees paediatric glaucoma, which is not available everywhere in the province. If a child has been diagnosed, or a paediatrician or optometrist is concerned, phone the rooms.
Speak to the rooms
Phone 012 252 8018 or 012 252 8123, WhatsApp 068 630 1580, or email info@eye-care.co.za.