It is important not to miss glaucoma drops, as missed doses lead to higher eye pressures, and over time this can lead to irreversible damage to the optic nerve. If you are not tolerating your eye drops, further advice should be sought to find a suitable alternative treatment. Some drops cause cause allergies, and alternative medications may be better suited. Patients who miss eye drops are unfortunately more likely to develop progressive glaucoma. The most common reason for missing drops is just forgetting. Try to get into a routine with drop instillation, and if you are missing drops periodically, consider having a calendar or diary to mark off when drops are taken. One useful tip is to always take the drops just after doing some other daily routine, eg brushing teeth. If you forget drops and normally put in drops late at night, consider an earlier application eg after an evening meal.

There are many advantages to eating a healthy diet. In the long-term this may affect your risk of cardiovascular disease, which in turn is indirectly linked to glaucoma. There is little evidence that suggests that any dietary supplementation affects the course of glaucoma. There are hundreds of randomised controlled trials (the gold standard in scientific research) that demonstrate the benefit of glaucoma medications in controlling eye pressure, but there is no convincing data as yet on the use of dietary supplementation.

For those interested in maintaining a healthy diet in any case, here is a list of foods that are high in anti-oxidants, which some people believe may play a role in maintaining healthy eyes.

• Citrus fruits
  
  

• Vitamin C, E

• Berries

• Tomatoes

• Peppers

• Cabbage

• Broccoli

• Brussels Sprouts

• Cauliflower

• Vegetable oils (wheat germ oil is especially rich in vitamin E)

• Wheat and other cereal grains

• Green leafy vegetables

• Egg yolk

• Milk fat

• Butter

• Meat

• Nuts

• Seafood

• Avocados

• Liver

• Egg yolks

• Whole milk

• Carrots

• Sweet potato

• Kale Turnip greens

• Pink Grapefruit

• Broccoli

• Apricots

• Beet greens

• Collard greens

• Papaya

• Red Peppers

• Cheddar cheese

• Lean meat

• Seafood

• Eggs

• Green leafy vegetables

• Soybeans

• Peanuts

• Whole Bran

• Whole cereals

• Cheese

• Oysters

• Kale

• Collard greens

• Spinach

• Parsley (not dried)

• Celery

• Broccoli

• Lettuce

• Green peas

• Pumpkin

• Brussels sprouts

• Summer squash

• Corn

• Green beans

• Green peppers

• Cucumbers

• Green olives
  
  
  

Example of 'simulated' loss of field - glaucoma patients may not see objects in parts of the visual field - this can affect driving skills, and all glaucoma patients are required by law to advise the DVLA of their diagnosis.

What is glaucoma?
Glaucoma is the name of an eye condition in which the optic nerve develops signs of damage. In some cases, damage is caused by raised eye pressure. Others have an eye pressure within normal limits but damage still occurs because of a weakness of the optic nerve.

The most common form of glaucoma is chronic open angle glaucoma where eye pressure rises very slowly. If untreated, over many months or years, the field of vision gradually becomes impaired. Chronic glaucoma is more common with increasing age. It is uncommon below the age of 40, affecting 1% of people over this age and about 5% over 65. If you have a close relative who has chronic glaucoma, then you should have regular eye tests. This is especially important if you are age over 40.

Acute glaucoma is much less common. This happens when there is a sudden rise in eye pressure. It can be quite painful and can cause permanent damage to sight if not treated properly.

How is glaucoma detected?
Tests for chronic glaucoma are carried out as part of a regular eye test. Viewing the optic nerve by shining a light from a special torch into your eye, measuring the eye pressure using one special instrument and testing your fields of vision with another, which shows a sequence of spots of light on a screen.

How is glaucoma treated?
The main treatment for chronic glaucoma aims to reduce the eye pressure. It is usually started with eye drops but can involve a small operation to reduce the pressure. Immediate hospital treatment may be required with acute glaucoma.

Can glaucoma be cured?
Although damage already done cannot be repaired, with early diagnosis and treatment, damage can usually be kept to a minimum.

Optic disc showing moderate cupping - a sign of glaucoma.

Normal pressure glaucoma can be very effectively treated with SLT (selective laser trabeculoplasty). The eye pressure can drop from 20mmHg down to as much as 8-10mmHg with laser. One issue with SLT is that some patients (approximately 1 in 20) may not respond to treatment, and the average drop in IOP is about 5-7mmHg - yet the treatment is safer than surgery and does not carry a risk of serious infection as with surgery.

For more information about SLT, please visit: http://www.selectivelasertrabeculoplasty.co.uk

Migraines are associated with visual disturbance and some patients experience "zig zag lines" and the sensation of flashing lights. Migraine is commoner in those with Normal Pressure Glaucoma.