Dr Skalicky is an internationally recognised glaucoma specialist in Melbourne.
Glaucoma is a condition where the intraocular pressure or fluid pressure inside the eye results in damage to the optic nerve. High eye pressure levels can cause progressive damage to the optic nerve that transmits vision from the eye to the brain. Glaucoma causes progressive damage to the optic nerve, which can result in irreversible vision loss.
Glaucoma vs Normal optic nerve
What causes high levels of eye pressure?
Fluid circulating in the eye is produced and drained at a balanced rate. If drainage becomes blocked, the eye pressure rises. This increased eye pressure can cause ongoing damage to the optic nerve leading to vision loss and blindness seen in glaucoma.
Detecting glaucoma early?
If detected early, glaucoma can be treated by lowering the eye pressure. This slows down or halts the progression of the disease. However, if detected too late, damage to the optic nerve from glaucoma cannot be undone.
The earlier glaucoma is detected and treated, the more vision can be preserved; ideally treatment begins before the disease causes the symptoms of reduced vision.
Dr Skalicky is a highly regarded glaucoma specialist dedicated to his patients, students, ongoing glaucoma research and organisations that fight glaucoma locally and internationally. He firmly believes that with early detection, persistent monitoring and the right treatment approach, glaucoma can be halted in its tracks.
Types of glaucoma:
- Primary open angle glaucoma. Microscopic obstructions to the drainage pathways in the eye.
- Primary angle closure glaucoma. The drainage area is obstructed by the iris.
- Pseudo-exfoliation glaucoma. Small particles of dandruff-like material clog up the drainage pathways.
- Normal tension glaucoma. Some individuals are susceptible to normal or even low eye pressure.
How do I know if I have glaucoma?
Glaucoma can be difficult to detect. Mostly it progresses slowly and affects peripheral vision first. This often goes unnoticed. More so, we are generally unaware of our eye pressure. This is why glaucoma usually remains undetected until the late stages of the disease. Therefore, If you are older than 40 years or have a family history of glaucoma you should be screened.
Glaucoma Treatment Options
Treatment by lowering the pressure in your eyes has been shown to reduce or halt progression of glaucoma.
Strategies to reduce the eye pressure include:
1. Gentle laser (SLT)
Glaucoma – what is it?
Glaucoma occurs when pressure in the eye damages the optic nerve connecting the eye to the brain. This can lead to permanent visual loss.
What causes high pressure in the eye?
Fluid circulating in the eye is produced and drained at a balanced rate. If drainage becomes blocked, the eye pressure rises.
What are the early symptoms of glaucoma?
Glaucoma is a disease in which damage to the optic nerve results in vision loss.
There are several forms of glaucoma; the two most common are primary open-angle glaucoma (POAG) and angle-closure glaucoma (ACG). Open-angle glaucoma is often called "the sneak thief of sight" as it has no symptoms until significant vision loss has occurred.
Symptoms of Open-Angle Glaucoma
Typically there are no early warning symptoms or signs of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years.
Most people with open-angle glaucoma feel fine and do not notice any change in their vision at first because the initial vision loss is of side or peripheral vision, and the sharpness of vision (visual acuity) is maintained until late in the disease.
By the time a patient is aware of loss of vision, the disease is generally quite advanced. Vision loss from glaucoma is not reversible with any treatment, including surgery.
Because open-angle glaucoma has few warning symptoms or signs before damage has occurred, it is important for people over 40 to have regular eye examinations. If glaucoma is detected during an eye exam, you will be referred to an eye doctor who can provide a preventative treatment to help protect your vision.
In open-angle glaucoma, the angle in your eye where the cornea meets the iris is as wide open as it should be, but the eye’s drainage channels become clogged over time, causing eye pressure to rise and subsequent optic nerve damage. It is the most common type of glaucoma, affecting about 300,000 Australians, half of whom do not know they have the disease.
You are at increased risk of glaucoma if your parents or siblings have the disease, if you have myopia (are short-sighted), diabetes or take certain medications that increase eye pressure (e.g. steroid medications). The risk of glaucoma also increases with age.
Symptoms of Acute Angle-Closure Glaucoma
- Severe eye and head pain
- Nausea or vomiting
- Hazy or blurred vision
- Halos around bright lights
- Sudden sight loss
In angle-closure glaucoma (also known as narrow angle glaucoma), the angle is closed in many or most areas, causing raised eye pressure that leads to optic nerve damage and vision loss. This rise in eye pressure may occur gradually or suddenly (an acute attack of angle closure). When angle-closure glaucoma occurs gradually it does not cause any noticeable symptoms until it is advanced, like Open Angle Glaucoma. There are also early stages of the disease in which the angle is closed but the eye pressure may or may not be raised and the optic nerve is not yet affected.
Symptoms of acute angle-closure glaucoma are often dramatic, and damage occurs quickly. If you experience any of these symptoms, seek immediate care.
If you are diagnosed with glaucoma, it is important to attend regular examinations with your eye doctor to monitor your condition and make sure that your treatment is effectively maintaining a safe eye pressure.
Is there anything I can do in my life to treat or prevent glaucoma?
A balanced, healthy diet with a variety of fresh fruit and green, leafy vegetables, and Omega-3 fatty acids (eg fish, some nuts) can be beneficial in glaucoma. Smoking and excessive drinking are harmful to the optic nerve and should be avoided. Yoga with head-down positions increases eye pressure and should be avoided.
The most important ways in which you can influence the progression of glaucoma is by:
- Attending all follow up appointments,
- Using your eye drops as directed, and
- Encouraging your close relatives to be screened for glaucoma.
I get pain around, or in my eyes. Could this be due to eye pressure?
Pain around the eyes is mostly this is due to an unstable tear film or dry eye. Raised eye pressure is usually painless, however high eye pressure can occasionally cause pain around the eyes and head.
Accreditations & Credentials
Dr Skalicky is an active clinician, surgeon, researcher, teacher, academic and health advocate who has published over 40 articles in international Ophthalmology journals. Known as an Ophthalmologist ahead of the times, Dr Skalicky’s career highlights are exceptional and atypical for his age.