Glaucoma Treatment in Cape Town

What to Expect After a Glaucoma Diagnosis

If your eye doctor recently diagnosed you with glaucoma, you may feel overwhelmed or unsure about what comes next. Glaucoma is a serious eye condition that can lead to vision loss if left untreated. However, with early diagnosis and the right glaucoma treatment, most patients can effectively manage the disease and preserve their sight.

Fortunately, modern treatments – such as eye drops, laser therapy, or surgery – can slow or stop further damage. By understanding how glaucoma affects your eyes and following your treatment plan, you can prevent further vision loss and continue living a full, active life.

What is Glaucoma?

Understanding Glaucoma and Eye Pressure

Your eyes naturally produce fluid that flows in and out to maintain healthy pressure. However, if you have glaucoma, this drainage system doesn’t function properly. Either your eye produces too much fluid, or the outflow becomes blocked. As a result, intraocular pressure (IOP) rises – damaging the optic nerve over time.

The optic nerve is responsible for sending visual signals to your brain. As pressure increases, it destroys the delicate nerve fibres, particularly those that manage your peripheral (side) vision. Eventually, if left untreated, glaucoma can lead to partial or total blindness.

Types of Glaucoma

Open-Angle Glaucoma (Most Common)

Open-angle glaucoma develops slowly and painlessly. Pressure builds gradually and damages your optic nerve over time – starting with side vision. Most people do not notice symptoms in the early stages. In some cases, even when eye pressure appears normal, vision loss still occurs. That’s why early detection is so important.

Closed-Angle Glaucoma (Less Common but Serious)

Closed-angle glaucoma causes a sudden spike in eye pressure and requires immediate medical attention to prevent vision loss. Symptoms can include:

Severe eye pain
Nausea or vomiting
Blurred vision
Halos around lights

There is also a chronic form of closed-angle glaucoma, which progresses more slowly and may have no noticeable symptoms until damage is advanced.

Other Types of Glaucoma

Glaucoma can also result from other health issues or eye conditions, such as:

Eye injuries or inflammation
Cataracts (clouding of the eye lens)
Eye tumors
Advanced diabetes (high blood sugar)
Uveitis (eye inflammation)
Genetic conditions

Why Early Detection Matters

Because glaucoma often shows no early warning signs, regular eye exams are essential – especially if you’re over 40 or have a family history of the condition. With timely diagnosis and proper glaucoma treatment, you can protect your vision and prevent further damage.

Who is Affected by Glaucoma?

Who Is at Risk for Glaucoma?

Age is the most significant risk factor for glaucoma. Chronic Open-Angle Glaucoma commonly affects individuals over the age of 40. However, if you’re over 35, it’s essential to get a comprehensive glaucoma screening at least every two years – even if you have no symptoms.

You are also more likely to develop glaucoma if:

A close family member has had glaucoma
You have high blood pressure or diabetes (high blood sugar)
You are severely short-sighted (high myopia)

These factors can increase your chances of developing optic nerve damage caused by elevated eye pressure. Therefore, early and regular testing plays a crucial role in protecting your vision.

How is Glaucoma Diagnosed?

Taking Your Medical History

Share Your Family and Medical History with Your Eye Doctor

Because glaucoma often runs in families, it’s important to inform your eye specialist in Cape Town if anyone in your family has been diagnosed with the condition. This information helps your doctor assess your risk more accurately.

Additionally, you should mention any chronic medical conditions that may influence your intraocular pressure, such as:

High blood pressure
Diabetes (high blood sugar)
Irregular heartbeat
Lung disease

Don’t forget to list all medications you’re currently taking. Some treatments can affect eye pressure, making early detection and personalised glaucoma care even more important.

Measuring Your Eye Pressure

How Eye Doctors Measure Eye Pressure

To check for glaucoma, your eye doctor in Cape Town uses a device called a tonometer to measure the pressure inside your eyes. This test is quick and typically painless.

First, your doctor will place numbing eye drops in your eyes. Then, a small plastic prism gently touches the surface of your eye to record the pressure. Alternatively, some clinics use a non-contact tonometer, which sends a soft puff of air onto your cornea to take the measurement.

Both methods help detect high intraocular pressure early – before it causes permanent vision damage.

Examining Your Optic Disc

How Eye Doctors Examine the Optic Nerve for Glaucoma

To monitor and diagnose glaucoma, your eye doctor in Cape Town examines the optic disc inside your eye for any signs of damage or change. This part of the eye is crucial, as it carries visual information from the retina to your brain.

📸 Fundus photography may be used to take detailed images of your optic disc. These images help track changes over time.

🔬 Additionally, advanced tools like OCT (Optical Coherence Tomography) and Heidelberg Retinal Tomography scan the optic nerve and retinal nerve fibre layer. These technologies detect even the smallest changes, allowing for earlier diagnosis and better treatment outcomes.

🔁 Annual testing is essential. To effectively manage glaucoma, you should undergo these optic nerve scans at least once a year – or more frequently if your eye specialist recommends it.

Checking Your Drainage Angle

Gonioscopy: Examining the Eye’s Drainage Angle

To check for glaucoma, your eye doctor will examine the drainage angle – the space between your iris and cornea where fluid drains from the eye. This part of the eye plays a critical role in regulating intraocular pressure.

👁️ First, your doctor will apply numbing eye drops to keep the procedure comfortable.

🔍 Then, using a special contact lens called a gonioscope, your doctor examines the angle using built-in mirrors. This allows them to clearly see whether the angle is open or closed – a key step in diagnosing open-angle or closed-angle glaucoma.

Regular gonioscopy exams are essential for early detection and management of glaucoma, especially if you’re at high risk.

Testing Your Field of Vision

Perimetry: Testing Your Peripheral Vision for Glaucoma

A visual field test, also known as perimetry, helps detect early signs of glaucoma by measuring your side (peripheral) vision.

👁️ During the test, you sit in front of a dome-shaped screen. Your eye doctor covers one eye and asks you to look straight ahead with the other.

💡 As small lights flash randomly inside the dome, you press a button every time you see one. This process creates a detailed map of your visual field – highlighting any areas where your vision may have weakened or disappeared.

📈 The results show whether you’ve lost any peripheral vision, which is often the first sign of glaucoma damage. Importantly, it’s recommended to repeat this test at least once a year to monitor changes over time.

Measuring Your Corneal Thickness (Pachymetry)

Corneal Thickness and Glaucoma Risk: Why Pachymetry Matters

Recent studies reveal that corneal thickness – measured through a test called pachymetry – is an important risk factor in developing glaucoma-related optic nerve damage.

🔍 A thinner cornea, especially one measuring less than 500 microns, combined with elevated intraocular pressure, significantly increases the risk of glaucoma. In fact, your corneal thickness not only helps determine your risk but also influences your glaucoma prognosis and treatment plan.

👁️ That’s why we always include pachymetry testing during your glaucoma screening. Understanding your corneal measurements allows us to better assess your overall risk and personalise your care.

How Can Vision Loss be Prevented?

Glaucoma Treatment: Prevent Further Vision Loss

Although your eye doctor cannot restore vision already lost to glaucoma, early treatment can help protect your remaining sight. In most cases, doctors can successfully lower intraocular pressure, which slows or stops further damage to the optic nerve.

🔬 Your glaucoma treatment plan depends on the type of glaucoma you have and how well it responds to medication. Typically, treatment begins with prescription eye drops or oral medication. However, if medication doesn’t work effectively, your ophthalmologist may recommend:

Glaucoma laser surgery to improve fluid drainage
Traditional glaucoma eye surgery for long-term pressure control

💡 Regular check-ups and timely treatment are essential to preserve your vision and manage glaucoma for the long term.

Glaucoma Treatment Goals

How to Control Eye Pressure in Glaucoma

To prevent vision loss caused by glaucoma, it’s essential to control the pressure inside your eyes. There are two ways to manage intraocular pressure:
you must either decrease fluid production or increase fluid drainage.

To reduce fluid production, your eye doctor may prescribe:

Specialised eye drops
Oral medications (pills) that slow down fluid formation in the eye

To improve fluid drainage, treatment options include:

Eye drops that help open the drainage channels
Laser treatment to clear or enhance the outflow pathways
Glaucoma surgery for more permanent pressure control

By tailoring the treatment to your specific condition, your ophthalmologist can help protect your vision and reduce long-term risk.

How is Glaucoma Treated?

1. Eye Drops and Pills

Eye drops and pills are the most commonly used glaucoma treatments.

2. Laser Treatment

Sometimes eye pressure can’t be controlled with eye drops and pills, or these medications cause side effects. In such cases glaucoma laser surgery (called a trabeculoplasty) is recommended. During a trabeculoplasty, the clogged drainage holes are opened with a laser. SLT Laser and Cyclodiodelaser Treatment is also recommended.

The SLT “cold” laser energy changes chemically and biologically selective pigment tissue from the drainage system of the eye. It is done in the Ophthalmologist’s office and does not hurt. It can reduce eye pressure by up to 10-30% and is effective for about 1 to 5 years. The procedure can then be repeated again. We also have other Lasers – a YAG laser can treat closed-angle glaucoma. In severe refractive and neovascular glaucoma (especially in diabetics), we can perform a diode laser cyclophotocouagulation.

3. Surgery

Glaucoma Surgery Options When Drops and Laser Aren’t Enough

Sometimes, eye drops and laser treatments aren’t enough to control your intraocular pressure. In such cases, your ophthalmologist may recommend glaucoma surgery to help preserve your vision and prevent further optic nerve damage.

When Is Glaucoma Surgery Recommended?

Your eye doctor may suggest glaucoma eye surgery if:

Your eye pressure remains high despite using multiple medications
You experience severe side effects from your current treatment
Your glaucoma continues to worsen (progressive disease)
Laser treatment is not a suitable option for you

Trabeculectomy – A Common Glaucoma Procedure

The most commonly performed glaucoma surgery is trabeculectomy. During this procedure, the surgeon creates a new drainage channel in the eye, allowing fluid to bypass the blocked natural outflow pathway. This helps to reduce eye pressure and protect your optic nerve.

Implant-Assisted Glaucoma Surgery

To enhance the success of trabeculectomy, surgeons may place a collagen implant under the flap. Other implant options include:

Ahmed valve
Mini Xpress implant

🧑‍⚕️ Dr Johann Krüger has performed these advanced procedures since 1989 and is highly experienced in managing complex glaucoma cases.

The Trabectome Procedure

Another effective surgical option is the Trabectome. This minimally invasive procedure helps improve fluid drainage and stabilise intraocular pressure. It is:

Safe
Cost-effective
Easily combined with cataract surgery

Xen Gel Stent & iStent

Your surgeon might also recommend:

The Xen gel stent – a surgical implant used to treat open-angle glaucoma
The iStent – a tiny device that restores your eye’s natural drainage ability

Glaucoma Treatment Goals

Take Control of Your Glaucoma Treatment Today

Although glaucoma cannot currently be cured, you can still protect your vision. With early diagnosis, regular check-ups, and the right treatment plan, many people manage glaucoma successfully and maintain their quality of life.

Stay Proactive With Your Eye Health

New medications and advanced glaucoma treatments are continuously being developed. However, the most important step you can take today is to:

Use your prescribed eye drops or medication consistently
Visit your eye doctor in Cape Town regularly for pressure checks and monitoring

By doing so, you can slow the progression of glaucoma and preserve your eyesight for years to come.

Contact Us for Glaucoma Eye Care in Cape Town

📞 Need more information about glaucoma treatment or surgery? Call us at 021 910 0300. Our friendly team at Eye Laser Clinic is ready to assist.

We operate from dedicated eye hospitals in Tygervalley and the V&A Waterfront, Cape Town. Both facilities are fully equipped for glaucoma and cataract surgery, as well as other eye procedures.

We Work With All Major Medical Aids

Eye Laser Clinic is a designated service provider for:

Discovery Health
Fedhealth
Bonitas
Profmed
Genesis
GEMS
KeyHealth
Momentum
Medihelp
Transmed

We also welcome private patients without medical aid.

Most hospital plans and medical aids cover:

Glaucoma surgery
Cataract procedures
Retinal surgery
Corneal and refractive procedures

Book Your Eye Consultation

The first step is easy:
👉 Schedule an ophthalmic assessment with one of our experienced eye surgeons in Cape Town today.

Glaucoma Treatment

in Cape Town

If your doctor recently told you that you have glaucoma, you may be wondering what that means, what glaucoma treatment entails and how it can affect your sight. Glaucoma is a serious disease, but in most cases it can be diagnosed and controlled. The following information can help you learn more about glaucoma and what you can do in order to prevent further loss of vision and lead a normal life.

What is Glaucoma?

Fluid always flows through the inside of your eye but if you have glaucoma, the outflow is abnormal, or your eye produces too much fluid. As a result, the pressure inside your eye rises and it slowly destroys the delicate fibres in the optic nerve that send visual messages to the brain. As nerve fibres die, the optic disc changes. Nerve fibres that control side vision are damaged first. If your pressure remains high, it can eventually cause blindness.

OPEN ANGLE GLAUCOMA is the most common kind of glaucoma. Pressure inside the eye rises slowly and destroys vision gradually, starting with side vision. This usually causes no pain and there are no other warning signs. In some cases vision may be lost, even though pressure stays within a normal range.

CLOSED ANGLE GLAUCOMA is less common. Pressure inside the eye rises suddenly and must be lowered right away to prevent blindness. Severe pain and blurred vision can occur with an acute attack. A chronic form of closed angle glaucoma occurs more slowly and often without any symptoms.

OTHER KINDS OF GLAUCOMA can be linked to an injury or inflammation of the eye, a cataract (clouding of the lens of the eye), an eye tumour, advanced diabetes (high blood sugar), uveitis, or other genetic causes.

Who is Affected by Glaucoma?

The major risk factor is age. Chronic Open Angle Glaucoma most often affects people over 40, but everyone over 35 should be tested at least every two years. You also have a higher risk of developing glaucoma if a close family member has had the disease or if you have high blood pressure or high blood sugar (diabetes). People who are very short-sighted are also at higher risk of developing glaucoma.