Dr. T Fletcher Calls for Glaucoma Checks Before the Year Closes

Glaucoma is often described as the silent thief of sight, and for good reason. In its most common form it causes no pain and no change in vision in the early stages, and it can damage the optic nerve for years before a person notices anything is wrong. Dr. Taryn Fletcher, an ophthalmic surgeon practising in Bryanston, Johannesburg, is encouraging adults who have not had a full eye examination recently to book one before the year closes, particularly if they fall into one of the higher-risk groups.

November is a natural moment for that kind of check. Many people use the weeks before the December break to deal with health appointments they have been putting off, and an eye examination is easy to forget because, with glaucoma, there is usually nothing to prompt it.

What glaucoma does to the eye

Glaucoma is a disease that damages the optic nerve, the cable of more than a million tiny nerve fibres that carries information from the eye to the brain. It usually develops when fluid builds up in the front part of the eye. In a healthy eye, that fluid drains out through an area called the drainage angle, keeping the pressure inside the eye stable. When the drainage angle does not work properly, pressure rises and starts to damage the nerve.

As the nerve fibres die, blind spots develop in the field of vision. Because these usually begin at the edges of sight, many people do not notice them until a large part of the optic nerve has already been lost. Glaucoma is a leading cause of blindness in people over 60, yet blindness from glaucoma can often be prevented with early treatment. The damage that has already occurred cannot be reversed, which is why finding the disease early matters so much.

Two main types

The most common form is primary open-angle glaucoma. It develops gradually, a little like a slowly clogging drain, and is painless with no early change in vision. Some people have optic nerves that are sensitive even to normal eye pressure, which raises their risk further.

Angle-closure glaucoma happens when the iris sits very close to the drainage angle and can block it. When the angle is blocked completely, pressure rises quickly in what is called an acute attack. This is a true eye emergency. Warning signs include suddenly blurred vision, severe eye pain, headache, nausea or vomiting, and seeing rainbow-coloured rings or halos around lights. Anyone with these symptoms should contact an ophthalmologist immediately. Angle-closure glaucoma can also develop slowly, without symptoms, until the damage is severe.

Who should be checked

Some people have a higher than normal risk of glaucoma. According to the information Dr. Fletcher's practice provides to patients, this includes people who are over 40, have family members with glaucoma, are of African or Hispanic heritage, have high eye pressure, are farsighted or nearsighted, have had an eye injury, have corneas that are thin in the centre, or have diabetes, migraines, poor circulation or other conditions that affect the whole body. People with more than one of these risk factors face an even higher risk.

For a city as diverse as Johannesburg, that list covers a large share of the adult population. A conversation with an ophthalmologist in Johannesburg about personal risk is the starting point for deciding how often an examination is needed.

Why a pressure test alone is not enough

Dr. Fletcher's practice stresses that a glaucoma screening that only checks eye pressure is not enough to find the disease. The only sure way to diagnose glaucoma is a complete eye examination. During that examination the ophthalmologist measures eye pressure, inspects the drainage angle, examines the optic nerve for damage, tests peripheral vision, takes a picture or computer measurement of the optic nerve and measures the thickness of the cornea.

Taken together, those measurements show not only whether glaucoma is present but how far it has progressed and how quickly treatment needs to start. This is the kind of assessment that ophthalmologists are trained to carry out and interpret.

How glaucoma is treated

Glaucoma is usually controlled with daily eye drops that lower the pressure inside the eye, either by reducing the amount of fluid the eye produces or by helping it drain better. Laser procedures and surgery are also used to help fluid leave the eye. The aim of every treatment is to stop further damage.

Eye drops can have side effects, and patients are advised to give their doctor a full list of the medicines they take, never to stop or change glaucoma medication without speaking to their ophthalmologist, and to ask about refills before running out. Dr. Fletcher has also written about the link between glaucoma and dry eye, which affects many glaucoma patients. Preservatives in some glaucoma drops can irritate the surface of the eye, and preservative-free drops can ease symptoms for some patients. Air conditioning and long hours of screen time, both common in an office summer, can make dry eye worse.

Other symptoms that should not wait

While glaucoma itself is usually silent, the practice also reminds patients of symptoms that do need prompt attention. A sudden shower of new floaters, especially with flashes of light, can mean the gel inside the eye is pulling away from the retina, and in some cases that the retina is tearing or detaching. Anyone who notices this, including while away on holiday, should seek medical attention immediately. Finding an ophthalmologist quickly in that situation can make a real difference to the outcome.

About the practice

Dr. Fletcher specialises in microincision cataract surgery, glaucoma and medical retinal disease, as well as aesthetic ophthalmology. She qualified in medicine at the University of the Witwatersrand in 2005, worked as a medical officer at St John Eye in 2008, qualified as an ophthalmologist in 2013 and opened her own practice in 2014 after working as an honorary consultant at Helen Joseph Hospital. Her professional memberships include the Ophthalmological Society of South Africa, the European Glaucoma Society and the European Society of Cataract and Refractive Surgeons.

The practice is open Monday to Friday from 8:00 to 17:00. Patients who would like to book a glaucoma assessment before the end of the year, or learn more about the conditions the practice treats, can visit https://drtfletcher.co.za/.

About Dr. T Fletcher

Dr. Taryn Fletcher is an ophthalmic surgeon in private practice at Bryanston Place Office Park, 199 Bryanston Drive, Bryanston, Johannesburg. The practice specialises in microincision cataract surgery, medical retinal disease and aesthetic ophthalmology, and also treats glaucoma, age-related macular degeneration, pterygium and flashes and floaters.

Media Contact
Dr. T Fletcher
Email: info@drtfletcher.co.za
Phone: +27 11 463 2958
Website: https://drtfletcher.co.za/