NEWS & EVENTS

Five common misconceptions about glaucoma: an expert view

FEATURE - 22ND SEPTEMBER 2021

Mr Nicholas Strouthidis of Moorfield Private addresses some of the many myths about glaucoma, one of the leading causes of blindness in the UK

Glaucoma is a group of eye conditions characterised by damage to the optic nerve and, if left untreated, can lead to a permanent loss of vision. Despite being one of the leading causes of blindness in the UK, glaucoma is the subject of many myths and misconceptions. Here is the expert view on some of them from Mr Nicholas Strouthidis, consultant ophthalmic surgeon at Moorfields Private.

1. Glaucoma only affects the elderly
Generally speaking, the risk of developing glaucoma increases with age. However, it can also affect younger people if they have a family history of glaucoma or if there is another factor involved, such as having an inflammatory eye condition (called uveitis), taking steroids or having had retinal or corneal surgery. All of these could potentially cause the eye pressure to go up and lead to secondary forms of glaucoma at an earlier age. There are a number of genetic predisposing factors, and children can also be affected by primary congenital glaucoma. Therefore, some individuals are at risk of developing glaucoma at a younger age, but in most circumstances the risk increases as you get older.

2. If you have perfect vision and no eye problems, you will never develop glaucoma
This is not true. Glaucoma is a progressive condition which may not display any symptoms in its early stages. But over time, if left untreated, it causes gradual progressive irreversible loss of vision, which eventually could become very debilitating. So early detection, made by an ophthalmic specialist following an optometrist identifying a concern at a routine eye test, is essential for stalling the condition’s development and preventing any future visual loss.

3. Glaucoma only occurs if you have elevated eye pressure
Historically, glaucoma was always thought to be associated with high intraocular pressure. In reality, we find that a significant proportion of glaucoma patients (approximately 30%) never have high pressure in their eyes. The mainstay of treatment remains lowering eye pressure, whether that be by pressure-lowering drops, laser treatment or surgery, regardless of the intraocular pressure level at the presentation.

4. There is no reason to treat glaucoma if you have no symptoms, especially since there is no cure anyway
Glaucoma is the second leading cause of irreversible blindness worldwide. If glaucoma is left untreated, the risk of progressive loss of vision increases, which in the first instance may not be symptomatic. Uncontrolled glaucoma may cause a person to lose their driving license and affect their ability to be independent in their daily life. This may not happen to every patient with untreated glaucoma, but I wouldn’t advise anybody to take their chances with glaucoma, especially people at higher risk of the disease progression due to their age, family history or contributing eye conditions.

5. Glaucoma progression could be halted by lifestyle changes such as yoga and other physical exercise
There is laboratory evidence that exercise and calorie restriction may reduce the chance of glaucoma progression, but this has not been demonstrated in clinical practice with patients. Generally speaking, maintaining a good level of fitness is helpful for any health concerns. In theory, yoga can affect some glaucoma patients, but not in a positive way: in people with very advanced glaucoma, there is a concern that prolonged head-down postures in some yoga positions may increase the chances of their condition worsening. In practice, it’s very hard to identify which postures could do this and for how long you need to be in these yoga positions. As long as your glaucoma is treated, the effects of these yoga positions should be minimal.