What is glaucoma and how is it treated?


Glaucoma causes blindness, and often the patients present too late.

The eye is a closed globe and the pressure inside the eye varies between 10 and 20mmHg. The pressure is maintained by fluid formed inside the eye that drains at a controlled rate out of the eye to maintain this desired pressure.

In glaucoma the pressure inside the eye rises due to inadequate drainage of fluid, putting pressure on the nerve of the eye causing permanent damage. The result is a gradual loss of vision over several years. The fact that the loss in vision is so gradual is one of the reasons patients often present too late. The other reasons is the fact that there are no warning signs like pain, and also initially only the peripheral vision is affected. We do not notice any loss in peripheral vision, but only later in the gradual progression of the disease when the central vision is affected do we recognize the loss in vision. The vision lost is however permanent and cannot be reversed.


It would stand to reason then that the main aim of the treatment of glaucoma is prevention. Every patient that present to the practice for whatever reason is evaluated for the possibility of glaucoma. Evaluating the intra-ocular pressure and appearance of the optic nerve are two easy and non-invasive tests performed on all patients. We all have a risk of developing glaucoma, but some are more prone than others. Older age and farsightedness are risk factors for developing glaucoma, as well as a family history of glaucoma. It is very important to maintain a high vigilance for glaucoma. The optic nerve damage is usually quite advanced by the time the structural damage is obvious. In suspicious cases the visual field needs to be evaluated. The test only takes a few minutes to perform and evaluates the peripheral vision and is therefore very accurate in picking up early glaucoma damage. The test is unfortunately very subjective and relies heavily on the patients’ cooperation. We use the Humphrey field analyzer that is very accurate with the latest software to perform an accurate test in the shortest possible time. If this test is inaccurate, an OCT (optic coherence tomography) of the optic nerve is performed, and often used as an adjunctive to confirm the optic nerve damage. The OCT is a laser that accurately measures the nerve fiber layer that constitutes the optic nerve. These two tests are not only essential in the diagnosis of glaucoma, but maybe even more important in evaluating progressive optic nerve damage.

The diagnosis of glaucoma is unfortunately often not clear cut, and in these cases sequential visual fields or OCT evaluations will indicate progressive damage and therefore confirm the diagnosis. You’r welcome to Contact us if you would like us to test you for glaucoma.

For most individuals the only treatment necessary is a topical eye drop that needs to be used daily. This will lower the intra-ocular pressure and prevent further visual loss and most importantly blindness.

Dr. Frikkie Hartog

Dr. Frikkie Hartog is an ophthalmic surgeon specializing in cataract and laser refractive surgery. The aim of all types of refractive surgery is to rid a patient of his spectacle or contact lens dependence. Dr Frikkie Hartog has a special interest in affording his patients the best possible results using the latest and safest technology. It is also essential to balance the increasing cost of these technologies with the financial expectation of your patients. Dr.Frikkie Hartog studied at the University of Stellenbosch and acquired his MMed Opth as well as FC Ophth degree in 2004. He has been performing cataract surgery since 2000 and laser surgery since 2005, and he has an excellent safety and success record. Frequent attendance of not only local but also overseas specialist congresses forms part of a continued learning interest. Dr. Frikkie Hartog is an avid cyclist and loves reading and spending time with his family.