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Glaucoma Treatment

Glaucoma is a group of conditions that result in progressive damage to the optic nerve, causing loss of visual field or peripheral vision. Because the rate of damage is usually slow, it can go unnoticed by patients, who often have no other symptoms until very late.

Increasing age, a family history of glaucoma, other eye conditions like myopia and diabetes, and certain medications increase the risk of developing Glaucoma. Measurement of the eye pressure alone is not adequate to diagnose glaucoma, as a significant proportion of patients have normal tension or low pressure glaucoma.

Glaucoma assessment involves monitoring the individual’s vision and eye pressure, as well as measurements of the nerve fibre layer and visual field. At Forest Eye Surgery, we use the gold standard in visual field assessment (the Humphrey visual field machine) and optical coherence tomography (OCT) scans to assess and monitor glaucoma.

Treatment of glaucoma involves lowering of the eye pressure, in order to prevent further damage to the optic nerves. This can in most cases be achieved with eye drops and/or laser (selective laser trabeculoplasty - SLT).
Equipment used to perform  selective laser trabeculoplasty

Equipment used to perform selective laser trabeculoplasty

A retinal nerve fibre scan

A retinal nerve fibre scan

A visual field test report

A visual field test report

Selective Laser Trabeculoplasty is used when eye drop medications do not lower the eye pressure enough or cause significant side effects. It may also be used as initial treatment in glaucoma in those who wish not to use eye drops.

SLT is usually performed in the doctor’s rooms over 2 sessions for each eye. The effect usually takes 6 weeks to appear. SLT lowers the pressure by about 25% when used as initial therapy. The effect will generally last between 1-5 years, and occasionally, longer than that. If the effect wears off over several years, the procedure can be repeated.

If SLT does not lower the pressure, then the glaucoma is treated by other means such as medications or conventional surgery. The laser does not affect the success of these other types of treatment. Despite the above treatments, a small group of patients with advanced or aggressive glaucoma go on to need glaucoma filtration surgery in order to lower eye pressure adequately and maintain vision.

It is important to note that none of the above treatment options cure glaucoma or reverse vision that has already been lost. They simply stop or minimise further vision loss. As such, early detection of glaucoma is key to maintaining good vision. Whatever method is used to treat glaucoma, appropriate follow up and testing with your eye doctor is crucial. Unfortunately, established damage cannot be reversed, so early detection is the key to maintaining vision.

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Dr Dana Robaei - Sydney Ophthalmologist

Dr Dana Robaei

Ophthalmic Surgeon MBBS(Hons) BSc(med) MPH PhD FRANZCO

Dr Dana Robaei is a consultant ophthalmic surgeon, with fellowship training in Cataract Surgery and Corneal Transplantation from Moorfields Eye Hospital, and Medical Retina from Sydney Eye Hospital.

She has extensively published in the national and international ophthalmic literature, and presented at international ophthalmology conferences.

She specialises in Cataract Surgery, Pterygium Surgery, Macular Degeneration and all aspects of comprehensive ophthalmology.

Dr Robaei is committed to clinical and surgical excellence, with the aim of providing the highest possible standard of care based on the latest available evidence, in combination with effective communication to patients and their referrers.

Professional Qualifications

  • Graduated from UNSW with Honours, Bachelor of Medicine, Bachelor of Surgery
  • Master of Public Health, UNSW
  • PhD in medicine (Visual impairment in Australian School Children)
  • Advances specialty training in ophthalmology and ophthalmic surgery at Sydney Eye Hospital
  • Subspecialty fellowship training in cataract surgery and corneal transplantation at Moorfields Eye Hospital, London UK
  • Clinical Senior Lecturer in ophthalmology, University of Sydney
  • Consultant Ophthalmologist, Westmead Hospital
  • Director of Forest Eye Surgery, Frenchs Forest