How is glaucoma diagnosed?

The diagnosis of glaucoma is based on the pressure in the eye, the visual field changes, and the thickness of the cornea. And you put all that together so you can make the diagnosis that the patient has glaucoma.

It’s important that you make a definitive diagnosis because when you start someone on treatment, that’s for life.

The treatment consists of eyedrops and there are four basic types of drops and we add them sequentially, just enough to give a control of the intraocular pressure. And what we do is to give a target pressure that the eye needs to achieve and give the appropriate treatment for that.

If eye drops fail, it is possible to carry out laser treatment. And if laser treatment fails, it is possible to carry out a surgical procedure in which, in a sophisticated way, you make a hole in the eye to allow fluid to drain out and that will lower the pressure on a more consistent basis. That is really not the treatment of choice because there are potential complications. For example, if you do produce a procedure where is a whole allowing fluid out of the eye then infection can get into the eye. And it’s a surgical procedure at the end of the day which we’re always very keen to avoid.

More about Paul Rosen

Paul Rosen is a Consultant Ophthalmic Surgeon at The Grange Eye Consultants. His special expertise is in laser eye surgery, cataract surgery, and the treatment of Age-related Macular Degeneration, glaucoma, and retinal diseases. He has over 20 years experience in treating people with eye problems. Paul is invited to lecture on cataract and refractive surgery both nationally and internationally. He leads clinical trials investigating novel eye treatments. Paul has served as the President of the UK and Ireland Society of Refractive Surgeons and is currently the President of the European Society of Corneal and Refractive Surgery. More recently I’d been appointed as a member of the NICE Cataract Guidelines Committee and also on the Refractive Surgery Subcommittee of the Royal College of Ophthalmologists.