Glaucoma Surgery

Glaucoma Surgery Icon by Brisbane Ophthalmologist Dr David Gunn.

What is a glaucoma?

Glaucoma is a common eye disease characterized by progressive damage to the optic nerve. The main risk factor for development and progression of glaucoma is elevated water pressure inside the eye.

There are multiple types of glaucoma, but by far the most common is primary open angle glaucoma.

How is glaucoma diagnosed?

Routine optometry screening involves checking the water pressure inside the eye (the intraocular pressure or “IOP”) as well as examining the appearance of the optic nerve in the back of the eye. If the optometrist is concerned about either of these, they will perform a test of the visual field – the periphery of the vision. Optometrists are trained to detect glaucoma, and if they are concerned they will refer a patient to an ophthalmologist to confirm the diagnosis.

How do you know if you have glaucoma?

It can be very difficult! Glaucoma has been nicknamed “the thief of sight” because most people suffering from the disease are completely unaware of it. Most will not feel a pressure feeling in their eyes and they will feel their vision is normal. Unfortunately, if someone becomes aware of their glaucoma due to poor vision it is usually already very advanced. We aim to detect and treat glaucoma before it gets anywhere this stage.

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My parent had glaucoma, does that mean I am at risk?

Glaucoma unfortunately runs in families. There are a variety of genes that have been associated with glaucoma, though we do not do genetic testing in glaucoma routinely yet. Having a family member be diagnosed with glaucoma puts you at increased risk but definitely does not guarantee you will get glaucoma. If you have a family member that has been affected, it is wise to regularly see an optometrist to have your eye pressure checked as well as have your nerve examined.

How is glaucoma treated?

Optic nerve damage from glaucoma cannot be reversed with current technology. The aim of treatment is to slow progression to a rate that allows vision to be preserved. This is achieved by reducing the intraocular pressure by eye drops, laser, stents or drainage operations. The vast majority of patients with glaucoma have and keep excellent vision.

I use my drops but my eyes sting or are red, are there any alternatives?

This is a common problem with eye drops. This can be a side effect of the preservatives in the medication or of the medication itself. We recognise that long-term use of medications with side effects for a disease for which you don’t have any symptoms is very challenging. Given the significant inconvenience, side effects and cost of eye drops, Dr Gunn offers laser glaucoma treatment as well as minimally invasive glaucoma stents to minimize or remove the use of eye drops.

How can my glaucoma be treated with laser?

Selective laser trabeculoplasty or “SLT” is a gentle laser procedure that has become a first line treatment in primary open angle glaucoma. The painless procedure is performed in the clinic by Dr Gunn and takes around 10 minutes. SLT lowers intraocular pressure by 20-30% over 6 weeks. It is effective in 80% of patients and lasts between 1 and 5 years. If required, the laser treatment can be repeated. SLT can be used alone to treat glaucoma, or be combined with eye drops if stronger treatment is required.

What is a glaucoma stent?

As an anterior segment surgeon, Dr Gunn is a specialist in minimally invasive glaucoma surgery. This surgery involves placement of a microscopic stent to allow fluid to escape the eye, often combined with cataract surgery. At the time of cataract surgery, adding in a glaucoma stent at the end of the operation adds little to no risk and could reduce or stop your need for glaucoma eye drops. Dr Gunn uses the iStent and Hydrus trabecular bypass devices.

Close up of a Hydrus device used in Glaucoma Surgery by Brisbane Ophthalmologist Dr David Gunn.
Close up view of hydrus in patient eye used in Glaucoma Surgery by Brisbane Ophthalmologist Dr David Gunn.

I am uninsured, can I still have my surgery with Dr Gunn?

Dr Gunn offers intermediate surgery through the Mater Hospital Brisbane for patients who are uninsured. This is an affordable option that allows you to have your surgery with an experienced corneal surgeon in a timely manner without requiring health insurance.