Chronic Glaucoma

Who is at risk of chronic glaucoma?

There are several factors which increase the risk:
  • Age: Chronic glaucoma becomes more common with increasing age. It is uncommon before the age of 40. It affects 1% of people over 40 and 5% of those over 65
  • Race: People of African origin are at increased risk of glaucoma
  • Family history: If you have a close relative who has glaucoma you should have a glaucoma check at regular intervals as advised by your eye doctor, especially if you are over 40. You should also advise other members of your family to do the same
  • Short sightedness: Short sighted people are more likely to develop chronic glaucoma
  • Diabetes: People with diabetes are more likely to develop chronic glaucoma

What effect does chronic glaucoma have on vision?

The danger with chronic glaucoma is that your eye may seem perfectly normal for many years. There is no pain to indicate that anything is wrong. Your eyesight will initially seem to be unchanged but is becoming progressively more damaged.

The early loss in the field of vision is in the shape of an arc above and / or below the centre of vision when you are looking straight ahead. Your ability to read an eye chart is initially not affected. If the glaucoma is not detected and treated, your central vision becomes more and more constricted until you develop tunnel vision. In long standing untreated glaucoma, complete blindness may result.

How is chronic glaucoma detected?

There are four tests for glaucoma.
  • Measuring the pressure in the eye with special instruments
  • Looking through the pupil at the optic nerve at the back of the eye
  • Checking for deficiencies in the visual field with a test that shows you a sequence of spots of light on a screen
  • Measuring the thickness of the nerve fibre layer at the back of the eye

How is chronic glaucoma treated?

Treatment for chronic glaucoma aims to reduce the pressure in your eye. Initially eye drops are used to do this. These act by reducing the amount of fluid produced inside the eye, or by opening up the drainage channels of the eye.

An alternate or adjunct to drops is SLT Laser

What does Selective Laser Trabeculoplasty (SLT) involve?

SLT Laser, is a gentle but effective laser alternative which lowers intraocular pressure (IOP) in some patients. SLT uses short pulses of low energy light to target the melanin- rich cells in the trabecular meshwork. These gentle laser pulses stimulate the body’s natural healing mechanisms. The meshworks is rebuilt with increased porosity, increasing aqueous outflow and reducing IOP.

This form of treatment is less traumatic than previous surgical or laser interventions and lowers IOP without the side-effects and compliance issues associated with drug therapy.

How is SLT performed?

SLT is performed as an outpatient in Dr Hornsby’s Rooms and only takes a few minutes. Eye drops are administered for anaesthesia and to prepare the eye prior to treatment. The laser is applied through a specially designed microscope.

There may be some minor visual disturbances following this procedure and we therefore recommend that you do not drive home afterwards.

People are selected on an individual basis for this treatment and SLT is not suitable for everyone with chronic glaucoma. It should be noted that some people may still require drug therapy or further SLT treatments following a single procedure.


Some patients will require an operation called a Trabeculectomy. A small cut is made in the outer layer of the eye and a titanium tube is inserted to allow the fluid inside the eye to drain out in a controlled way. After the operation a small blister forms and remains under the upper lid. This blister contains the drainage fluid.
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The information provided here is for general education only and should not be construed as individual medical advice. For advice relevant to your particular situation, please speak to Dr Hornsby.