One of the most sight-threatening diseases we look for as part of your comprehensive eye examination is glaucoma. This common disease, known as the silent thief of sight, affects 300,000 Australians and can lead to permanent blindness.

Picking it up early and treating it with prescription eye drops or surgery can dramatically reduce the risk of going blind from glaucoma.

This disease runs in families. If one of your parents has it, your risk is around 10%. If one of your siblings has it, your risk is even higher. If you have glaucoma in your family, or a family member has recently been diagnosed with this disease, you should have your eyes thoroughly checked.

How we test your eyes for glaucoma

Glaucoma CANNOT be diagnosed with a quick and simply eye test. Many people are under the mistaken impression that a measurement of intraocular pressure can determine if they have glaucoma or not. This is not the case.

Glaucoma can only be diagnosed by collecting information about the optic nerve, peripheral vision (through a visual field test), family history and other risk factors (including corneal thickness, intraocular pressure and general health) and putting these findings together like a jigsaw puzzle. Only then can the practitioner diagnose the disease.

Glaucoma's effect on the optic nerve.

Tests you will have

Even with no risk factors or family history, all patients of the The Eye Practice have the following tests:

Retinal imaging: a picture is worth a thousand words, especially when it comes to baselining the health of your eyes. Capturing the unique appearance of your retina while it is young and relatively healthy, gives us the best possible tool to monitor change in your eyes over time.

OCT (Optical Coherence Tomography): See our OCT page for more information.

Central corneal thickness: thinner than average corneas are associated with a higher risk of developing glaucoma.

Visual field screening: All patients have a frequency doubling threshold (FDT) test to look for early signs of glaucoma or neurological defects. If your results are suspicious, or if there are other reasons to suspect glaucoma, you will have a more detailed visual field test called a Humphrey Visual Field.

Intra-ocular pressure: This may be measured with a non-contact method (puff of air on the eye) or, if glaucoma is suspected, with the gold standard Goldmann Applanation Tonometer.

If you have glaucoma or are suspected of having it, you will also have a test called gonioscopy. This test uses an angled mirror (similar to a dentist’s mirror) to examine the angle inside your eye where your iris meet your cornea.

What if I have glaucoma?

If you’re diagnosed with glaucoma, the usual first line of treatment is glaucoma eye drops, often used once a day for the rest of your life. If we diagnose glaucoma in your eyes, you will be referred to an ophthalmologist to confirm your diagnosis.  You can usually continue to have treatment and monitoring with our optometrists unless you have an aggressive or complicated form of glaucoma, which will be best managed by a glaucoma specialist.

Surgery may also be appropriate – sometimes instead of or as well as the eye drops. This is performed by an ophthalmologist. At The Eye Practice, we work closely with a number of ophthalmologists to comanage – or share the care of – our patients.

What happens next?

If you have glaucoma, you will need a check up every 6 months (and a little more often in the first year) to look for any progression of your disease.

If your test results show that you are losing more peripheral vision, (or losing more of your optic nerve fibres) your treatment will need to be changed.

Additional treatments may need to be added to adequately control your disease and prevent blindness. At these regular reviews, you can expect to have a visual field test (which tests your peripheral vision) an OCT and a photograph of your optic nerve.