Treat Glaucoma Early to Minimise Visual Loss

This is a case of a patient whose glaucoma was identified at an early stage and with treatment, the patient avoided unnecessary morbidity and had an optimal outcome.

A 75 year old Caucasian male attended his local optician practice (Eye Opticians) for a routine review and was noted to have raised pressure inside the eye. There was a family history of glaucoma and he was referred to his local eye department for further assessment and treatment. He was informed of a long delay before being seen (see article on “Why is my glaucoma appointment delayed and what can I do about it?“).

The patient decided to consult Mr Mohamed privately in March 2018. He underwent a comprehensive assessment and was noted to have high intraocular pressure of 30mmHg right eye and 24mmHg left eye (normal eye pressure around 15mmHg with a range of 10-21mmHg) with some early damage to the right optic nerve suggestive of glaucoma.

The images below show the appearance of the optic disc in the two eyes (the right one showing early damage from the high eye pressure)

He was started on medical treatment (eye drops) and over the next 6 months, his intraocular pressure was controlled to 14mmHg in both eyes using two different eye drops. Serial assessment of his optic discs and visual fields show that his glaucoma is now stable (last assessment at time of writing this article – January 2020).

His rapid assessment and treatment under the care of Mr Mohamed meant that his disease was stabilised before significant damage had been done to his optic discs and he is able to maintain normal vision.

He has since received the appointment for assessment in the local eye unit but chooses to continue private treatment under the care of Mr Mohamed.

The concern with such cases is that delay in initial assessment and treatment can lead to extensive damage to the optic disc resulting in irreversible visual loss which can sometimes be very extensive (see case of visual field loss in progressive glaucoma).

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