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Your guide to glaucoma

Man having an eye test with an optician - glaucoma

Glaucoma is a condition often affecting the sight of both eyes. Very few symptoms may be detected at the early stages of development, which can mean that the condition is completely missed.

A late diagnosis of symptoms, or misdiagnosis for another eye condition can result in complete loss of vision.

However, sight can be preserved  and irreversible blindness can be prevented if glaucoma is correctly diagnosed and treated as quickly..

Your GP / doctor or eye specialist may have been negligent ’ if a delay in referral and diagnosis led to: 

  • Complications needing invasive treatment.
  • Prolonged treatment.
  • Unnecessary pain and suffering.
  • Reduced vision
  • Blindness

To bring a successful clinical negligence claim it is necessary to prove that the care and treatment received fell below a generally accepted standard, and caused preventable harm or loss.

Your Legal Friend has many years experience in successfully resolving many different types of clinical negligence cases. Our specialist knowledge of both legal and medical issues, together with a sensitive understanding of how everyone involved is affected, means:

  • We can help you find out the reason why you or a member of your family was not given the duty of care owed.
  • We can help you obtain justice and compensation.
  • We can help you ensure the future financial needs of providing the necessary special care, support treatment and equipment will be properly met.

Glaucoma statistics...

  • Glaucoma is one of the most common eye conditions in primary and secondary care and the second most common reason for registration of a visual impairment.
  • 9 -12 per cent of glaucoma cases are registered by people over the age of 65 years.
  • Over 70 per cent of cases are primary open-angle glaucoma (POAG), one of the main types of glaucoma.     (British Medical Journal - BMJ, 2013)
  • 2 per cent of visual impairment and 8 per cent of blindness in the UK is the result of glaucoma, the leading cause of irreversible blindness in the world.
  • Between 1990 and 2010, glaucoma was responsible for a worldwide doubling in the number of years that older people live with a disability.   (The World Health Organization, 2010) 

What is glaucoma?

Glaucoma is a disease of the eye in which fluid constantly produced by the eye fails to drain away fast enough. Both eyes can be affected although one eye may develop the condition quicker than the other one.

The build up of excess fluid - known as the intraocular pressure – can cause damage to the retina (light-sensitive nerve tissue at the back of the eye) and the optic nerve, which sends signals from the eye to the brain.

A delay in treating damage to the nerve can lead to irreversible blindness.

Types of glaucoma and their symptoms

There are four main types of glaucoma:

Chronic or Primary Open-Angle Glaucoma  (POAG) – the most common type of glaucoma, which develops very slowly.

Symptoms: a gradual of loss of vision which starts at the edge of the eye, usually in the shape of an arc ‘seen’ a little above and/or below the centre of vision when looking straight ahead. The onset of symptoms is not always noticed or diagnosed before the disease has spread both outwards and inwards, and permanent damage has already occurred.

Acute Angle-Closure Glaucoma – which can develop rapidly with a sudden, painful build-up of pressure. Symptoms of acute glaucoma are not constant, but can last for one or two hours and cause further damage.

Symptoms include:

  • intense pain
  • redness / tenderness 
  • headache, feeling sick
  • seeing halos or 'rainbow-like' rings around lights
  • cloudy vision
  • rapid loss of vision in one or both eyes

Secondary Glaucoma – mainly occurs as a result of an eye injury or another eye condition, such as inflammation of the middle layer of the eye.

Developmental Glaucoma (congenital glaucoma) – a rare but sometimes serious type of glaucoma which occurs in very young children.

Symptoms include:

  • enlarged eyes caused by pressure and expansion
  • sensitivity to light
  • cloudy appearance
  • watery eyes
  • jerky eye movements
  • a squint causes one of the eyes to turn inwards, outwards or upwards, while the other eye looks forward.

Other types of glaucoma include:

Low-tension glaucoma - where eye pressure is normal but optic nerve damage still occurs.

Pigmentary glaucoma – which can develop during early or middle adulthood and may occur after exercise or sport. Pigment granules from the back of the iris are dispersed within the eye. Fluid flow is affected and leads to a rise in eye pressure.

Glaucoma risk factors

Primary Open-Angle Glaucoma  (POAG) - factors which can increase your risk of developing the most common type of slowly-developing glaucoma, are:

  • Age - this type of glaucoma  is more common above the age of 40.
  • Family - you are at a higher risk of developing glaucoma if a close family member has the same condition.
  • Race - people of Black African / Caribbean origin are at higher risk and are more likely to develop a severe form of the condition at an earlier age.
  • Short sightedness.
  • Diabetes.

Acute Angle-Closure Glaucoma -  People of Asian origin are more at risk of developing this rapidly progressive form compared with those from other ethnic groups.

Testing for glaucoma

Diagnosis of glaucoma will require a number of important tests to be carried out, as follows:

Eye pressure test (tonometry) - measures the pressure inside the eye (intraocular pressure).

A small amount of dye is placed onto the cornea – the transparent layer of tissue that covers the front of the eye.  A blue light from the head of the tonometer device is held against the eye to measure the pressure.

Central corneal thickness – the depth of the cornea is also measured because of the affect upon internal eye pressure measurements. 

Gonioscopy - a lens is placed against the eye to examine the front outer edge between the cornea and the iris (the coloured part of your eye) where the fluid should drain out of the eye. This test can help to determine whether the angle is open or closed (blocked).

Visual field test (perimetry) –  a check for missing areas of vision. A sequence of light spots will be displayed and the patient is asked which ones can be seen. Some dots will appear in the area known as peripheral vision (around the sides of the eyeball), which is where glaucoma begins. If spots are not seen in  the peripheral vision, it may indicate the glaucoma has caused damage.

Optic nerve assessment – to determine if the optic nerve, which sends signals from the eye to the brain has been damaged. The pupils are enlarged by the use of eye drops and the eyes are then examined using a microscope with a very bright light, known as a slit lamp.

Referral

If glaucoma is suspected  - a referral to an eye specialist should be promptly arranged for further tests to confirm a diagnosis and to determine:

  • How far the glaucoma has developed.
  • How much damage has been caused to the eyes.
  • What caused the condition.

If Closed Angle Glaucoma is suspected - an immediate referral for treatment must take place.

Treatment

Once a diagnosis has been confirmed, the treatments for Glaucoma can involve:

  • Eye Drops
  • Tablets
  • Laser treatment
  • Surgery

Any damage to the eyes cannot be reversed, which means that treatment will simply aim to control the condition and minimise future damage.

Primary Open-Angle Glaucoma (POAG) – Patients will need lifelong monitoring so that any progression of visual damage can be detected.

Glaucoma – claiming for negligence

Early and accurate diagnosis and treatment are crucial to preventing glaucoma from causing any further damage to the eyes and the ability to see.

You may have good grounds to believe that the standard of appropriate care fell below expectation if your GP or doctor was found responsible for:

  • Misdiagnosing glaucoma for another eye condition.
  • Causing a delay in carrying out appropriate eye tests, diagnosis and treatment.
  • Failing or delaying to arrange a referral to an eye specialist.
  • Failing or delaying an immediate referral for urgent treatment if Closed Angle Glaucoma is suspected.

How Your Legal Friend can help you..

Your Legal Friend are experienced clinical negligence specialists. We know that you will want to find out why your GP or doctor failed you or a family member in providing the expected standard of appropriate care in the diagnosis and treatment of glaucoma.

Our task is to ensure:

  • Your voice will be heard and your case is made.
  • The person responsible is brought to account for the additional harm and suffering caused.

No amount of compensation for clinical negligence will be able to reverse the damage caused when the diagnosis or treatment of glaucoma is delayed or failed to be properly tested.

Your Legal Friend  is committed to ensuring victims of clinical negligence obtain answers, and receive justice and compensation to ensure future medical treatment and care needs are properly met.