Recognizing Glaucoma Symptoms | SpecSMART Eye Clinic Ikoyi

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Recognizing Glaucoma Symptoms | SpecSMART Eye Clinic Ikoyi

By Dr. Deborah Oparaji (OD)

Glaucoma is known as the “silent thief of sight” because it damages vision slowly and painlessly, often without noticeable symptoms until significant, irreversible damage occurs. Early detection is crucial to prevent vision loss. This guide explains common presentations and red flags, and how SpecSMART Eye Clinic Ikoyi uses advanced tools like the Henson 9000 perimeter and Topcon Maestro OCT with the Hood Report for diagnosis and monitoring.

Why Glaucoma Is “Silent”

  • Glaucoma involves progressive degeneration of retinal ganglion cells and their axons, causing optic nerve changes and loss of visual fields.

  • Visual system redundancy means large nerve fiber loss can occur before vision gaps are noticed.

  • Slow progression with preserved central vision leads patients to underestimate vision loss.

Who’s At Risk?

  • Age over 40 years

  • Positive family history (first-degree relatives)

  • High intraocular pressure (though can occur at normal pressures)

  • High myopia with long axial length

  • History of ocular trauma or surgery

  • Systemic vascular risks like hypertension or diabetes

  • African or African-Caribbean ancestry

Symptoms & Patient-Reported Clues

  • Intermittent blind spots, especially peripheral

  • Difficulty adapting to low light

  • Frequent changes in spectacle prescription

  • Halos or glare (also common in cataracts)

  • Sudden severe eye pain or vision loss (emergency)

Clinical Examination Components

  • Visual acuity and refraction

  • Intraocular pressure measurement (Goldmann tonometry)

  • Gonioscopy for angle classification

  • Dilated optic nerve examination (cup-to-disc ratio, rim shape)

  • Anterior segment exam for secondary causes

  • Ongoing suspicion guides functional and structural testing

Functional Testing: Henson 9000

  • Automated perimetry for visual fields

  • Fast, reliable, with fatigue-reducing algorithms

  • Detection of glaucoma-typical defects: arcuate scotomas, nasal steps

  • Supports progression monitoring

Structural Testing: OCT (Maestro)

  • High-resolution imaging of RNFL and ganglion cell layers

  • True-color fundus photos registered to OCT

  • Wide-field automated segmentation

  • Detects structural loss before visual field changes

Structure-Function Correlation: The Hood Report

  • Overlays visual field results on OCT maps

  • Highlights early damage missed by summary metrics

  • Facilitates targeted visual field testing

  • Enhances diagnostic accuracy and confidence

Practical Diagnostic Workflow at SpecSMART Eye Clinic Ikoyi

  1. Patient history and risk assessment

  2. Basic eye exam and IOP measurement

  3. Gonioscopy

  4. Dilated fundus exam with imaging

  5. Visual field testing with Henson 9000

  6. OCT scans with Maestro OCT

  7. Hood Report structure-function correlation

  8. Management planning or close follow-up based on findings

Important Patterns to Watch

  • Reproducible glaucomatous visual field defects

  • Progressive thinning on OCT scans

  • Significant asymmetry between eyes

  • Structure-function concordance or discordance guides diagnosis

Special Clinical Scenarios

  • Normal-tension glaucoma needs imaging and field loss confirmation

  • Pre-perimetric glaucoma requires monitoring and sometimes early treatment

  • Secondary glaucoma treated by addressing underlying condition

  • Advanced glaucoma features late central vision loss, underscoring early detection

Patient Communication Tips

  • Explain glaucoma’s silent progression

  • Describe use of OCT and visual fields for confident diagnosis

  • Emphasize importance of imaging even with normal IOP

  • Encourage monitoring and early treatment to preserve vision

Follow-up and Monitoring

  • Frequency depends on risk and disease stage

  • Annual or sooner for low-risk suspects

  • Every 3–6 months for suspicious changes

  • Every 6–12 months or more for stable glaucoma

  • Re-evaluation after treatment initiations

Case Example

A 56-year-old man with no symptoms but positive family history diagnosed with early glaucomatous damage via combined Henson 9000 and Maestro OCT testing at SpecSMART Eye Clinic Ikoyi. Treatment initiated with scheduled monitoring.

Final Takeaways

  • Glaucoma is initially symptomless; active screening is vital

  • Combine clinical exam, visual fields, and OCT for accurate diagnosis

  • SpecSMART Eye Clinic Ikoyi uses advanced technologies for reliable care

  • Early detection and management preserve sight, improve outcomes

When to Get Tested

If you are over 40, have family glaucoma history, African ancestry, high myopia, eye trauma, or steroid use, schedule comprehensive eye exams including OCT and visual fields at SpecSMART Eye Clinic Ikoyi. Early detection saves vision.

FAQs

What is glaucoma?
A group of optic nerve diseases causing vision loss, often without early symptoms.

Who is at risk for glaucoma?
People over 40, with family history, high eye pressure, or of African descent.

How is glaucoma diagnosed?
Through eye exams, visual field testing with Henson 9000, and OCT imaging.

Why is early detection important?
Glaucoma damages vision gradually and undetected, early treatment can preserve sight.

How often should I get tested?
Depends on risk; annual to biannual for low-risk, more frequent if progressive.

📍Contact SpecSMART Eye Clinic Ikoyi

Ikoyi Plaza, Keffi Street, Ikoyi.
📞 0701 820 7486

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