Search results

Open-angle, angle-closure, normal-tension and secondary glaucomas explained. An expert guide from Mr Alex Baneke, consultant ophthalmologist in Essex. A Guide for Patients Understanding Glaucoma: The different types Glaucoma is a complex eye condition that can lead to vision loss if not properly managed. There are several types of glaucoma, each with its own characteristics and treatment options. This guide will help you understand the various forms of glaucoma and what they mean for your eye health. Glaucoma is a manageable condition with early detection and appropriate treatment. By lowering eye pressure through eye drops, laser treatment, or surgery, it’s possible to slow the progression of the disease and protect your vision. Always discuss with your eye specialist which treatment options are best suited for your specific needs. A Guide: Understanding the different types of glaucoma Glaucoma comes in various forms, each requiring a tailored approach to treatment. Whether you have Primary Open Angle Glaucoma, Primary Angle Closure Glaucoma, Normal Tension Glaucoma, Ocular Hypertension, or secondary glaucoma, managing eye pressure is key to protecting your vision. Your eye specialist will guide you through the best treatment options based on your specific type of glaucoma and overall eye health. Primary Open Angle Glaucoma (POAG) Primary Open Angle Glaucoma (POAG) is the most common form of glaucoma. In POAG, the pressure inside the eye (intraocular pressure) is higher than normal, typically above 21-24mmHg. This increased pressure leads to damage to the optic nerve, known as "cupping," which can cause a gradual loss of peripheral vision. In POAG, the drainage angle of the eye is open, which can be confirmed through a simple test called gonioscopy, where a lens with a small mirror is placed on the eye. The main issue in POAG is that fluid drainage from the eye’s anterior chamber is impaired due to a blockage in the drainage channels (trabecular meshwork). You can think of it like a bath where the plug is clear, but there’s a blockage further down the pipe that causes the water to rise. Treatment for POAG usually begins with eye drops or Selective Laser Trabeculoplasty (SLT) to lower eye pressure. If these treatments aren’t sufficient, surgery may be necessary. You can find more detailed information about surgical options in the Treatment section of this website. Read More about Surgical Treatment and Laser Primary Angle Closure Glaucoma (PACG) In Primary Angle Closure Glaucoma (PACG), the drainage angle is closed, leading to increased eye pressure and optic nerve damage. This type of glaucoma can be identified using gonioscopy. In PACG, the iris blocks the trabecular meshwork, preventing fluid from draining properly and causing a rise in eye pressure. Treatment for PACG often starts with eye drops, Yag Laser Peripheral Iridotomy (PI), or cataract surgery. Yag PI involves creating a small hole in the iris to allow fluid to bypass the blockage, which helps open up the drainage angle. Cataract surgery can also help by replacing the natural lens with a thinner artificial lens, providing more space for fluid to drain. In some cases, further surgery may be required if these treatments don’t adequately control the disease. PACG can develop slowly or suddenly. If it occurs suddenly, it’s known as Acute Angle Closure Glaucoma (AACG). Symptoms of AACG include severe headache, eye pain, nausea, seeing halos around lights, blurred vision, and a red eye. This is an eye emergency, and if you experience these symptoms, you should go to A&E or an Eye Casualty immediately. Eye Casualties are available at Southend University Hospital and Broomfield Hospital, but you will need a referral from the main A&E or an emergency optician. Some patients may have narrow drainage angles without developing glaucoma. These patients may be classified as having Primary Angle Closure (PAC) if the pressure is raised without optic nerve damage, or Primary Angle Closure Suspects (PACS) if the angle is narrow but the pressure is normal. Treatment is recommended for PAC, while patients with PACS can often be monitored by their optician annually, as the risk of progressing to glaucoma is low. Read More about Cataract Surgery Normal Tension Glaucoma (NTG) In Normal Tension Glaucoma (NTG), the pressure inside the eye is within the normal range (below 21mmHg), but there is still optic nerve damage and corresponding visual field loss. The drainage angle is open, as confirmed by gonioscopy. In NTG, factors other than eye pressure, such as blood supply to the optic nerve, mitochondrial function (how well the cell’s energy production parts work), and the pressure of the fluid surrounding the brain and optic nerve, may contribute to optic nerve damage. However, the only proven treatment for reducing the risk of vision loss in NTG is lowering eye pressure. Treatment for NTG typically starts with eye drops, though SLT (laser) may also be tried. However, SLT is often less effective in NTG because it works best when eye pressure is initially raised. In some cases, surgery may be necessary. There is ongoing research into using oral nicotinamide to improve mitochondrial function, which may emerge as a new treatment for NTG. Read More about Eye Drops Ocular Hypertension (OHT) Ocular Hypertension (OHT) is a condition where the pressure inside the eye is elevated (above 21-24mmHg) without any signs of optic nerve damage or visual field defects. About 1 in 10 patients with OHT will develop glaucoma over a 5-year period, but treatment can reduce this risk to 1 in 20. In OHT, the drainage angle is open, but there may be a blockage in the drainage channels that prevents fluid from leaving the eye properly. Treatment for OHT is not always necessary, as not all patients will go on to develop glaucoma. The decision to treat is based on the patient’s risk factors and preferences. If treatment is recommended, it usually starts with eye drops or SLT (laser). Surgery is generally avoided in OHT unless the patient is at high risk of vision loss. Read More about Laser Secondary Glaucomas Secondary glaucoma occurs when increased eye pressure and optic nerve damage result from another eye condition or surgery. Conditions that can lead to secondary glaucoma include: Vitreoretinal surgery (e.g, for retinal detachment) Complicated cataract surgery Corneal graft surgery Use of steroid eye drops Uveitis (inflammatory eye disease) Uncontrolled diabetic eye disease (neovascular glaucoma) Eye trauma or injury Pseudoexfoliation (PXF) Pigment Dispersion Syndrome (PDS) In secondary glaucoma, the drainage angle may be open or closed, depending on the cause. Treatment will vary based on the underlying condition and may include eye drops, laser therapy, surgery, or a combination of these approaches. Read More GLAUCOMA UK Pseudoexfoliation (PXF) and Pigment Dispersion Syndrome (PDS) Pseudoexfoliation (PXF) involves the abnormal accumulation of protein deposits in the body, including the eyes. In some cases, these deposits block the trabecular meshwork, leading to increased eye pressure. Patients with PXF may experience faster disease progression, and surgery can be more challenging. Pigment Dispersion Syndrome (PDS) occurs when the lens inside the eye rubs against the iris, causing pigment to shed and potentially block the trabecular meshwork. Not all patients with PXF or PDS develop glaucoma, but if pressure increases, treatment options are similar to those for open-angle glaucoma. PDS patients should avoid high-impact sports, as these can increase pigment shedding. Activities like cycling and swimming are generally safer. Yag Laser Iridotomy may be offered to PDS patients who haven’t developed high eye pressure, as it might reduce the risk of raised pressure. However, once pressure is elevated, Yag Laser Iridotomy is less likely to help. Read More about Yag Laser MORE ABOUT GLAUCOMA AVAILABLE TREATMENTS CONTACT TO BOOK

Transparent pricing for private cataract surgery and glaucoma treatment in Essex. Self-pay and insurance options available. Mr Alex Baneke, consultant ophthalmologist. New appointments: £250 Included: full clinical examination, pressure checks, gonioscopy and a formal report to your GP/Optometrist. Excluded: specialized scans (OCT/VF) may incur a separate hospital fee. Cataract surgery: Conventional surgery with monofocal lens One eye: £3415 Both eyes: £6830 Trabeculectomy surgery: Price estimate including first 3 months of follow up visits (depending on hospital): £5800-£6200 Selective Laser Trabeculoplasty (SLT): Price estimate (depending on hospital) One eye: £900-£1000 Both eyes: £1400-£1600 Paul Tube surgery (including first 2 months of follow ups): £5800-£6500 Follow-up appointments: £200 Cataract surgery: Conventional surgery with premium (toric/EDOF/multifocal) lens One eye: £4506-£5100 Both eyes: £9012-£10200 Preserflo surgery: Price estimate including first 2 months of follow up visits ( depending on hospital ): £5800-£6500 Insured patients: Mr Baneke is fee-assured for all the major insurers and is a recognized provider for all major insurers including BUPA/AXA in Southend and Brentwood Yag Laser Periperal Iridotomy (Yag PI) unilateral: £700-900 Yag Laser Periperal Iridotomy (Yag PI) bilateral: £1000-£1300 Have a question about fees? Please call 07398 997592

What is glaucoma and how is it treated? A guide from Mr Alex Baneke, consultant glaucoma & cataract specialist in Southend and Brentwood, Essex. A Guide for Patients Understanding Glaucoma: An Introduction Glaucoma is a condition that damages the optic nerves, leading to a gradual reduction in your field of vision. Since this damage usually happens slowly, most people with glaucoma don’t realise there’s a problem until they’ve already lost a significant amount of vision. The good news is that with proper treatment, most patients with glaucoma do not go blind. Glaucoma is a manageable condition with early detection and appropriate treatment. By lowering eye pressure through eye drops, laser treatment, or surgery, it’s possible to slow the progression of the disease and protect your vision. Always discuss with your eye specialist which treatment options are best suited for your specific needs. What Causes Glaucoma? The main risk factors for glaucoma are increased eye pressure and age. The goal of treatment is to reduce eye pressure, which can significantly slow down the progression of the disease. Read More about Risk Factors and Prevention Advanced Treatment Options For more advanced glaucoma, surgical options may be necessary. These include: Trabeculectomy: A traditional surgical procedure that helps to lower eye pressure by creating a new drainage pathway for the eye fluid. Preserflo™ : A newer surgical option that also helps to reduce eye pressure with fewer potential complications than traditional surgery. Tube Surgery: This involves placing a small tube in the eye to help drain fluid and lower eye pressure. Additionally, there are various devices available under the category of "Minimally Invasive Glaucoma Surgery" (MIGS) , such as the Miniject™. These devices generally cause fewer complications than more traditional surgeries, but it’s important to note that many of them still lack strong evidence to fully support their long-term effectiveness. Read More How is Glaucoma Treated? Treatment for glaucoma typically begins with eye drops or laser therapy. Eye Drops: The most commonly prescribed eye drop in the UK is latanoprost. This medication reduces eye pressure by around 30% in most patients by increasing the flow of fluid out of the anterior chamber of the eye. Latanoprost is generally well tolerated, but it can cause some side effects such as slight redness, stinging, and increased eyelash growth. Laser Treatment: For initial laser treatment, Selective Laser Trabeculoplasty (SLT) is a safe and effective option for people with open-angle glaucoma. SLT works in about 70-80% of patients and can help control eye pressure for up to 5 years, potentially avoiding the need for eye drops. Read More TYPES OF GLAUCOMA AVAILABLE TREATMENTS CONTACT TO BOOK

Suffering from dry, sore or gritty eyes? Learn about dry eye and blepharitis causes and treatments. From Mr Alex Baneke, consultant ophthalmologist in Essex. A Guide for Patients Dry eyes and blepharitis Dry eyes and blepharitis are both common conditions, which often occur together. Dry eye, also known as keratoconjunctivitis sicca, occurs when your eyes don't produce enough tears, or the tears they do produce aren't of the right quality. Blepharitis occurs due to inflammation of the eyelids, which is often associated with the growth of bacteria. Eyelids become red, and may have a crusty or sticky discharge, more noticeable in the mornings. Although uncomfortable, these conditions are not usually serious and there are things you can do to help. Management of dry eyes It is not uncommon for glaucoma patients to suffer with dry eyes. Symptoms include the feeling of dry, gritty eyes, increased redness, and increased watering. Some patients feel like there is something in their eyes and may experience episodes of blurring. Symptoms usually improve if the eyes are closed and if a preservative-free dry eye drop is applied. Unfortunately, dry eyes can be worsened by the use of eye drops to treat glaucoma. Some sensible advice to reduce the symptoms of dry eyes is set out below: Ensure you are well hydrated by increasing your intake of water and reducing your intake of drinks containing caffeine Reduce your heating, air conditioning and car fan settings Use wrap-around glasses if outside on a windy day, or when driving Stop or reduce contact lens wear Consider flaxseed oil or omega 3 supplement tablets Use a preservative free dry eye drop containing sodium hyaluronate or carmellose, 4-6 times per day (available over the counter) Use a preservative free gel for dry eyes containing carbomer or white soft paraffin, last thing at night before sleeping (available over the counter) Ask your ophthalmologist about switching to a preservative free glaucoma drop Ask your ophthalmologist to consider changing drops that are more likely to cause dry, uncomfortable eyes, such as Lumigan (bimatoprost) and Alphagan (brimonidine), to an alternative If using glaucoma drops, close your eyes after applying the drops and ensure you wipe any excess off your eyelids using a clean damp tissue. This will reduce eyelid irritation In severe cases, asking your ophthalmologist for a short course of steroid and antibiotic eye drops may help. Management of blepharitis Blepharitis is a condition causing inflammation of the eyelid margins. Though not infectious, it is associated with the growth of bacteria, and symptoms may be worsened by the use of glaucoma eye drops. Blepharitis can worsen symptoms of dry eyes. Patients with blepharitis may notice red, crusty or sticky eyelids on waking. Blepharitis is usually a long-standing condition and requires long term changes to manage. Sensible advice includes: Use a heated eye bag/eye mask (available online and from some opticians and pharmacies) 1-2 times a day before cleaning your eyelids Clean your eyelids every morning and evening with your eyes closed, using a clean flannel and warm tap water (this does not need to be boiled). Massage the lids towards the lid margins (the top eyelid down and the bottom eyelid up) Some people advocate using a gentle cleaner such as baby shampoo, or a pre-made wipe containing a cleaning agent, but the evidence is limited and it is probably better to use warm water alone If using glaucoma drops, close your eyes after applying the drops and ensure you wipe any excess off your eyelids using a clean damp tissue. This will reduce eyelid irritation Ask your ophthalmologist whether switching to a preservative free glaucoma drop would help Ask your ophthalmologist to consider changing drops that are more likely to cause dry, uncomfortable eyes, such as Lumigan (bimatoprost) and Alphagan (brimonidine), to an alternative Ask your ophthalmologist whether you would benefit from a course of oral antibiotics such as doxycycline or azithromycin In severe cases, asking your ophthalmologist for a short course of steroid and antibiotic eye drops may help. For a video explaining lid cleaning techniques in more detail please see below:

What is the link between eye pressure and glaucoma? Mr Alex Baneke, glaucoma specialist in Essex, explains why controlling eye pressure protects your sight. A Guide for Patients Understanding Intraocular Pressure (IOP) Intraocular pressure (IOP) refers to the pressure inside your eye, which is essential for maintaining its shape and function. Just like the air inside a balloon keeps it inflated, the fluid inside your eye keeps it firm and healthy. However, when the pressure becomes too high, it can lead to conditions like glaucoma, which can damage your vision if left untreated. This section will explain what IOP is, how it works, and why it’s important to manage it properly. If you’ve been diagnosed with raised intraocular pressure or glaucoma, your eye specialist will work with you to manage and monitor it effectively. Treatments might include eye drops, laser therapy, or surgery to lower your pressure and prevent further damage to your vision. Regular check-ups and measurements of your eye pressure are important to ensure your treatment is working as intended. What is Intraocular Pressure (IOP) ? OP is the pressure created by the fluid in your eye. The eye is filled with two types of fluids: aqueous humour, which is found in the front part of the eye between the iris and the cornea, and a jelly-like substance called vitreous humour, located at the back between the lens and the retina. The aqueous humour is produced by the ciliary body, just behind the iris, and flows through the pupil into the front of the eye. From there, it drains out through the trabecular meshwork, located where the iris meets the cornea, in an area known as the drainage angle. The balance between the production and drainage of this fluid is what creates intraocular pressure. If the drainage is blocked or slowed, or too much fluid is produced, the pressure inside the eye increases. Imagine your eye as a sink: the tap (ciliary body) is constantly producing fluid, which fills the basin (anterior chamber) and drains out through the plughole (trabecular meshwork). If the drain is blocked, the water (or fluid) builds up, causing the pressure to rise. Glaucoma and Intraocular Pressure In open-angle glaucoma, the drainage system doesn’t work as efficiently as it should, causing the fluid to build up and increase the pressure inside the eye. Treatments for this include eye drops to reduce fluid production or help improve drainage, laser therapy, or surgery to create new drainage pathways. In angle-closure glaucoma, the drainage angle is blocked by the iris, which acts like a rubber stopper over the plughole. This blockage causes a sudden spike in pressure, which can be very painful and requires emergency treatment. This might involve medication to lower the pressure or a laser treatment (called a laser iridotomy) to create a small hole in the iris, allowing fluid to flow freely. How Do We Measure Intraocular Pressure? Eye pressure is measured using a special instrument that gently presses against the cornea to gauge how firm or soft the eye is, similar to testing the firmness of a balloon by pressing on it. The measurement is given in millimetres of mercury (mmHg), and this helps eye specialists assess whether your eye pressure is within a healthy range. What is a Normal Eye Pressure? Most people have an eye pressure that falls between 10 and 24 mmHg. However, what’s considered a “normal” pressure can vary from person to person. Some people with eye pressure below 21 mmHg may still develop glaucoma (normal-tension glaucoma), while others with pressures above 24 mmHg may not show any signs of the disease (ocular hypertension). According to the National Institute for Health and Care Excellence (NICE), if your eye pressure repeatedly measures 24 mmHg or higher, you should be referred to a hospital eye service for further investigation. However, some individuals with glaucoma can experience damage even with lower pressures, especially those with advanced disease. Factors That Influence Intraocular Pressure Intraocular pressure can fluctuate throughout the day due to various factors. These include: Body Position: Lying flat can increase your eye pressure compared to sitting upright, which is why night-time spikes in pressure may occur. Exercise and Activity: Physical activity, breathing, fluid intake, and even wearing a tight shirt collar can affect your eye pressure. Medications: Both systemic (whole body) and topical (eye drops) medications can influence your pressure. Caffeine: Drinking caffeinated beverages may cause temporary increases in eye pressure. For people with glaucoma, these fluctuations are particularly important to monitor, as spikes in pressure can contribute to further damage to the optic nerve.

A Guide for Patients Eye care services in Essex There is an excellent range of eye-care services accessible to people residing in and around Essex, ranging from NHS or private hospital care, to high street opticians. This page summarises some of the services available. Eye Clinic Liaison Officers (ECLOs) ECLOs have lots of knowledge on eye conditions and on helpful local and national services. They provide emotional and practical support to anyone affected by sight loss, free of charge. They can advise on living with sight loss, management and treatment of eye conditions, visual aids, equipment and technology, availability of benefits and concessions, education and employment, certification and registration and other support and services that might be appropriate. By offering dedicated individual care, ECLOs can talk to you about your worries and give you advice on how to lessen the impact your eye condition may have on your life. ECLOs act as an important bridge between health and social services and are central to the support and wellbeing of patients in eye clinics. They also help prevent avoidable sight loss, by talking through treatment and helping people to understand their medication if necessary. The Southend ECLO is Tracey Meddle, who is employed by Southend-in-Sight, a local sight loss charity. Email: tracey@southendinsight.co.uk Tel: 01702 342131 The Orsett/Basildon ECLO is Sarah Jane Piper, who is employed by the charity BASIS. Email: Sarah-jane.piper@nhs.net Tel: 01268 522817 The Chelmsford ECLO is Holly Muncey, who is employed by the RNIB. Email: mse.eclomidsouthessex@nhs.net Tel: 07901 513416 Local charities BASIS is a sight loss charity providing help for patients with visual impairment in South Essex. Tel: 01268 522817 Email: admin@basissouthessex.org.uk Southend in Sight is a sight loss charity for Southend, providing help for patients with visual impairment. Tel: 01702 342131 Email: info@southendinsight.org.uk High street opticians offering glaucoma services Goldsmith Webb offers Goldmann Applanation Tonometry (GAT) which is a procedure that measures intraocular pressure (IOP), Humphrey Visual Field (HVF) analysis and Optical Coherence Tomography (OCT) which is a non-invasive imaging technique used to create cross-sectional images of the eye. Several Goldsmith Webb stores have optometrists with higher qualifications in glaucoma and offer emergency appointments. Goldsmith Webb has stores in multiple locations, including: Bodys The Opticians 25 Queens Road, Southend-on-Sea Essex, SS1 1LT Tel: 01702 354553 Goldsmith Webb 8 Grover Walk Corringham SS17 7LY Tel: 01375 677577 Goldsmith Webb 37-43 Broadway West, Leigh-on-Sea Essex, SS9 2BX Tel: 01702 710031 Humfrey Eye Care offers HVF, OCT services and emergency appointments. Humfrey Eye Care is run by Stuart Humfrey. He is an experienced optometrist with a higher qualification in glaucoma. 223 London Road Hadleigh Essex SS7 2RD Tel: 01702 599068 Euin Steele offers GAT, HVF and OCT services. Euin Steele has optometrists with higher qualifications in glaucoma and offers emergency appointments. 58 Orsett Road Grays Essex RM17 5EH Tel: 01375 37300 Karen Castle offers GAT, HVF and OCT services. 78 Hart Road, Thundersley, Essex, SS7 3PF Tel: 01268 793538 Forbes Opticians offers GAT, HVF and OCT services. Forbes Opticians has optometrists with higher qualifications in glaucoma and offers emergency appointments. 198 London Rd Hadleigh, Benfleet Essex SS7 2PD Tel: 01702 555345 James Bryan Opticians offers GAT, HVF and OCT services. James Bryan Opticians has optometrists with higher qualifications in glaucoma and offers emergency appointments. 33 The Meadows Shopping Centre Chelmsford Essex CM2 6FD Tel: 01245 357766 Emergency eye care If you have an emergency condition you can contact your GP, a local optometrist offering emergency appointments on the high street (self refer via www.primaryeyecare.co.uk , or contact one of the optometry practices on this page) or attend your local hospital Accident and Emergency Department. If you want private care, you are welcome to contact Mr Baneke’s private secretary to check whether he has any last-minute availability. The Mid and South Essex hospitals with an eye casualty department (referral is via GP, main A&E or a local optometrist) are: Southend University Hospital, Prittlewell Chase, Southend-on-Sea, SSO 0RY Broomfield Hospital, Court Road, Broomfield, Chelmsford, CM1 7ET Queens Hospital, Rom Valley Way, Romford, RM7 0AG For London patients: Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD (virtual assessment and phone triage service available via https://www.moorfields.nhs.uk/ae ) Essex Local Optical Committee Essex LOC is funded by Ophthalmic Contractors in the Essex area and acts on behalf of the Contractors, Performers, and others registered with the GOC in dealing with the NHS.

Practical advice on lifestyle changes for patients living with glaucoma, from managing eye drops to driving and diet. Written by glaucoma specialist Mr Alex Baneke in Essex. Living with Glaucoma For most people, glaucoma is a slowly progressing condition, and with the right treatment, many won’t notice a significant change in their vision. While glaucoma can cause some challenges, the good news is that most patients will not go blind. However, it’s important to be aware of how glaucoma can affect your daily life, especially as it progresses. In this guide, we’ll explain what it’s like to live with glaucoma, the impact on driving, and the support services available to help you. On this page Visual Field Loss Driving and Glaucoma Support Services and Charities Living with Glaucoma- daily activities Sleep and glaucoma Can lifestyle changes affect glaucoma? Help available for those with sight impairment Visual Field Loss Glaucoma primarily affects your peripheral vision, but in the early stages, many people won’t notice any changes. This is because the visual field loss often happens gradually, and one eye can compensate for the other. Additionally, the brain has an amazing ability to “fill in” gaps in your vision, meaning you might not realise you have any problems until the disease has advanced. Driving and Glaucoma Driving with glaucoma depends on how your visual field is affected. If you have glaucoma in one eye but normal vision in the other, you don’t need to inform the DVLA for personal car or motorbike licences. However, if both eyes are affected, or if one eye has glaucoma and the other is affected by a different condition, you must inform the DVLA and take a special visual field test for driving called the Esterman test. This test is done with both eyes open, and most people find it easier than the routine visual field tests performed in clinics. Patients who drive professionally (taxi, minibus or HGV drivers), are legally obliged to inform the DVLA even if their glaucoma only affects one eye. Fortunately, about 9 out of 10 people pass the Esterman test. If you don’t inform the DVLA and are involved in an accident, you could be fined or prosecuted. For those with a bus, coach, or lorry licence, you must inform the DVLA even if only one eye is affected by glaucoma. Medical professionals are required by law to inform the DVLA if a patient with glaucoma refuses to do so themselves. Patients can inform the DVLA of their condition online at https://www.gov.uk/eye-conditions-and-driving . Support Services and Charities If you’re living with glaucoma, there are many support services and charities that can help. Glaucoma UK and the Royal National Institute for the Blind (RNIB) provide advice, information, and courses on living with sight loss. They offer guidance on financial help, technology, employment rights, and caring for someone with sight loss. They also have helplines and websites for more information. Eye Clinic Liaison Officers (ECLOs) are available at most hospitals to provide direct support for patients experiencing vision loss. Ask your eye doctor for a referral to your local ECLO for help with accessing services and advice. Low Visual Aid Clinics offer tools and devices to help you manage day-to-day activities. If you are registered as sight-impaired or severely sight-impaired, you will also receive a needs assessment to help identify useful adaptations for your home. For more details on local services, the RNIB’s Sightline Directory offers links to resources for blind and partially sighted individuals. Living with Glaucoma: Daily Activities Research has shown that people with glaucoma in both eyes may find certain daily activities more challenging than those without the condition. For example, patients with visual field loss in both eyes may experience more difficulty with tasks like walking or reading. They may also walk more slowly and have an increased risk of tripping or falling, particularly if the lower part of their visual field is affected, which can make it harder to see steps or obstacles. Patients with glaucoma in only one eye tend to manage well with most day-to-day activities, as their vision in the unaffected eye compensates. However, as glaucoma progresses and affects both eyes, you may notice more difficulty navigating spaces or reading, and certain medications, like beta-blockers, may lower blood pressure and increase the risk of falls. Sleep and glaucoma Cells in the retina that detect light and help regulate your sleep-wake cycle, or your circadian rhythm, are damaged in glaucoma. There is evidence to suggest that this can make it harder for patients with advanced glaucoma to get a good night's sleep. Additionally, patients with sleep apnoea may be at higher risk of developing glaucoma. Lifestyle changes that may help patients with glaucoma to get a better night's sleep include increasing exposure to bright natural light during the day, and reducing exposure to bright lights in the evening. This will allow the remaining light-sensitive retinal cells to have as much impact as possible on the sleep-wake cycle. Taking melatonin supplements before bed may also help. Furthermore, some evidence suggests melatonin can reduce your intra-ocular pressure. Further helpful advice on sleep can be found at https://www.nhs.uk/every-mind-matters/mental-health-issues/sleep/ . Can lifestyle changes affect glaucoma? Leading a healthy lifestyle is important for patients with glaucoma. The two most important risk factors for glaucoma are intraocular pressure and age. Therefore activities that reduce intraocular pressure or the affect of aging on the body may slow the progression of glaucoma. Activities that can increase intraocular pressure and should therefore be performed in moderation for glaucoma patients, especially following glaucoma surgery, include the following: Yoga employing positions where the head is below the heart Heavy weight lifting Playing brass instruments, such as the trumpet High caffeine intake; moderate intake is probably fine, as caffeine is high in antioxidants, which may be protective against glaucoma Drinking large volumes of fluid over a short period of time Positive lifestyle changes that may slow the progression of glaucoma include: Regular exercise A healthy diet high in antioxidants, found in green leafy vegetables (kale and spinach), tomatoes, berries, nuts, dark chocolate, coffee (in moderation) and green tea Evidence from the Rotterdam Study suggests diets high in vitamin B3 (niacin) and B12 (cobalamin) are associated with a lower risk of glaucoma. B12 supplements are safe for most people, but B3 supplements can cause liver damage, cardiovascular disease and diabetes if taken at high doses, so speak to your doctor before taking vitamin B3 (niacin) tablets. Stopping smoking and reducing alcohol intake Meditation and activities that reduce stress Sleeping with the head slightly elevated on a pillow Driving and Glaucoma Daily activities Support Services and charities Sleep and glaucoma Lifestyle changes and glaucoma Help available for those with Sight Impairment If you are registered as sight impaired (SI) you may be entitled to these benefits and concessions: Free postage Free NHS eye examination Disabled person’s railcard Reduced/free bus fares Free directory enquiries Cinema pass for a carer Protection under Equality Act Assessment by Social Services Those registered as severely sight impaired (SSI) are additionally entitled to: Blind person’s tax allowance TV licence fee reduction Blue badge (car parking) You may also be eligible for additional benefits, including Personal Independence Payment (PIP), Attendance Allowance, Carer’s Allowance, and Universal Credit. Living with glaucoma doesn’t mean you have to stop doing the things you enjoy, but it’s important to be aware of how the condition might affect your vision, particularly as it progresses. Regular check-ups, following your treatment plan, and taking advantage of the support services available can help you manage your condition and maintain a good quality of life. For further information, don’t hesitate to reach out to charities like Glaucoma UK or the RNIB , or speak to your local Eye Clinic Liaison Officer for personalised advice and support.

Private Eye Surgery at Orsett Hospital, Grays Mr Alex Baneke offers private cataract surgery and glaucoma treatment at Orsett Hospital, Rowley Road, Orsett, Grays, Essex, RM16 3EU. Private appointments are available on Tuesday mornings. Orsett Hospital is available to self-pay patients only (not insured patients). No GP referral is needed. The clinic serves patients from Grays, Thurrock, Basildon, Billericay, and East London. BOOK NOW What to expect at your consultation During your first visit, Mr Baneke will carry out a thorough examination of your eyes, discuss your symptoms and explain your treatment options. Most new consultations last around 30 minutes. Getting here By car: Free parking is available on site. From Basildon: Approximately 15 minutes by car. From Billericay: Approximately 20 minutes by car. From East London: Approximately 30 minutes by car via the A13. By train: West Horndon station is the nearest rail link, approximately 10 minutes by taxi from the hospital. West Horndon is a 30-minute train ride from London Fenchurch Street, calling at Barking and Upminster. Before your appointment You can drive to most routine follow-up appointments. However, some appointments (including your initial consultation, your first post-operative consultation, and any consultation where your symptoms have changed) may involve dilating eye drops, which blur your vision for around 3 hours. You should not drive during this time. Please note: Orsett Hospital is available to self-pay patients only. If you have private health insurance, Mr Baneke also offers consultations and surgery at Southend Private Hospital (twice weekly) and Spire Hartswood Hospital, Brentwood (alternate weeks), both of which accept insured patients. You can book online for Southend Private Hospital and Spire Hartswood using the "Book Online" links on our website. BOOK NOW To book a private consultation, use the "Book now " link on our website (available for Southend Private Hospital and Spire Hartswood only), call Paige on 07398 997 592 , or email info@essexeyesurgery.co.uk .

Private Eye Surgeon Serving East London Spire Hartswood Hospital, Brentwood Spire Hartswood Hospital is approximately 25–35 minutes by car from most of East London via the A12 or A13. The full address is Eagle Way, Great Warley, Brentwood, Essex, CM13 3LE. Free parking is available on site — unlike most central London hospitals. Mr Baneke holds clinics at Spire Hartswood on alternate weeks. Appointments can be booked online or by calling Mr Baneke's secretary on 07398 997 592 . Looking for a private cataract surgeon or glaucoma specialist accessible from East London? Mr Alex Baneke offers private cataract surgery and glaucoma treatment at two clinics within easy reach of East London, often at lower cost than central London clinics. Free parking is available. From Barking or Dagenham: Approximately 25 minutes by car via the A13 and A127. From Ilford or Redbridge: Approximately 25 minutes via the A12. From Stratford or Canary Wharf: Approximately 30–35 minutes via the A12. BOOK NOW Orsett Hospital, Grays (self-pay patients only) Orsett Hospital is approximately 30 minutes from East London by car via the A13. The full address is Rowley Road, Orsett, Grays, Essex, RM16 3EU. Free parking is available on site. Mr Baneke offers private appointments on Tuesday mornings. This clinic is available to self-pay patients only (not insured patients). By train, West Horndon station is 10 minutes by taxi from the hospital and 30 minutes from London Fenchurch Street (via Barking and Upminster). Also available: Southend Private Hospital For more frequent appointment availability, Mr Baneke holds private clinics at Southend Private Hospital twice weekly. Southend is well connected by train from East London: Prittlewell station is just 16 minutes from Stratford, and Southend Central is 28 minutes from Upminster. Prittlewell station is a 12-minute walk from the hospital. Free parking is also available on site. What to expect at your consultation During your first visit, Mr Baneke will carry out a thorough examination of your eyes, discuss your symptoms and explain your treatment options. Most new consultations last around 30 minutes. Before your appointment BOOK NOW You can drive to most routine follow-up appointments. However, some appointments (including your initial consultation, your first post-operative consultation, and any consultation where your symptoms have changed) may involve dilating eye drops, which blur your vision for around 3 hours. You should not drive during this time. Mr Baneke is a consultant ophthalmologist specialising in cataract surgery and glaucoma. He trained at Moorfields Eye Hospital and sees patients from across Essex and East London, including Barking, Dagenham, Ilford, Stratford, Canary Wharf, Walthamstow and Newham. No GP referral is needed for a private appointment. To book a private consultation, use the "Book Online " link on our website (available for Southend Private Hospital and Spire Hartswood only), call Paige on 07398 997 592 , or email info@essexeyesurgery.co.uk .

Contact Essex Eye Surgery to book a private consultation with Mr Alex Baneke. Clinics in Southend and Brentwood, Essex. Call 07398 997 592 or email info@essexeyesurgery.co.uk. Contact Us Contact us to arrange a private consultation: 07398 997 592 / 01702 667 819 info@essexeyesurgery.co.uk BOOK ONLINE: SOUTHEND BOOK ONLINE: BRENTWOOD NHS referrals via your GP or optician Consulting rooms: Southend Private Hospital 15-17 Fairfax Drive Westcliff-on-Sea, Essex SS0 9AG 01702 667 819 Spire Hartswood Hospital Eagle Way, Brentwood CM13 3LE 01277 232525 Orsett Hospital Rowley Road, Orsett, Grays RM16 3EU 01268 524 900 Southend University Hospital Southend-on-Sea, SS0 0RY 01702 435 555

Am I at risk of glaucoma? Learn about risk factors including age, family history and ethnicity. Written by Mr Alex Baneke, glaucoma specialist in Essex. A Guide for Patients Understanding Glaucoma Risk Factors: "Why me?" If you’ve been diagnosed with glaucoma, you might be wondering, "Why me?". It's a common question. While certain causes like steroid use, trauma, or previous eye surgery are known, the reasons behind the most common type, primary open angle glaucoma, are not fully understood. However, we do know that glaucoma is a multifactorial disease, meaning there are various risk factors that can predispose someone to developing it. This page will help you understand these risk factors and how they may apply to you. The Bigger Picture Glaucoma is the leading cause of irreversible blindness worldwide. Read More Implications for Your Family Should they be tested? Read More Risk Factors What makes some people more likely to suffer from Glaucoma? Read More Diet and Lifestyle What you can do to improve your eye health. Read More Understanding the risk factors for glaucoma can help you take proactive steps in managing your eye health. Whether it’s monitoring your blood pressure, making healthy lifestyle choices, or ensuring regular eye tests, being aware of these risks is the first step in protecting your vision. If you have a family history of glaucoma or other risk factors, talk to your eye specialist about how you can best manage your eye health. The Bigger Picture Glaucoma is the leading cause of irreversible blindness worldwide. In the UK, about 2% of people over 40 have glaucoma, but it’s estimated that more than 50% of cases go undiagnosed. This means that for every person who knows they have glaucoma, there is likely another who has it but doesn’t know. In England alone, around 480,000 people have primary open angle glaucoma. The condition is more common in older adults, with 1 in 50 people over 40 and 1 in 10 people over 75 affected. What Are the Risk Factors for Glaucoma? Risk factors for glaucoma have been identified through years of observing people with the disease. These factors can be classified into two categories: modifiable and non-modifiable. Modifiable Risk Factors: These are risk factors you can change or control, such as managing high blood pressure. Non-Modifiable Risk Factors: These include things you cannot change, like your age or family history. Elevated Eye Pressure Most types of glaucoma are associated with high eye pressure. However, some people develop optic nerve damage from glaucoma even with normal eye pressure, a condition known as normal tension glaucoma. Currently, all glaucoma treatments focus on lowering eye pressure because it’s the only risk factor we fully understand and can manage effectively. High Blood Pressure The relationship between blood pressure and glaucoma is complex. Some studies suggest that high blood pressure can slightly increase eye pressure, while others indicate that low blood pressure, especially at night, might contribute to glaucoma. A sensible approach is to maintain blood pressure within a normal range and avoid extremes. If you’re on blood pressure-lowering medication, it’s important to inform your eye doctor, as adjustments to your medication might be necessary. Diet and Lifestyle While diet isn’t thought to have a significant impact on glaucoma, there’s some evidence that vitamin B3 (nicotinamide) might slow disease progression. It is found in red meat, poultry, fish, brown rice, nuts, seeds, legumes and bananas. However, there isn’t enough evidence yet for doctors to recommend it universally. Eating a healthy, varied diet and getting regular exercise are always good for overall health. Some studies suggest exercise and meditation are helpful for patients with glaucoma. Patients with pigment dispersion syndrome should avoid high-impact sports, as these can increase the risk of pressure spikes in the eyes; this does not apply to patients with other types of glaucoma. Other Risk Factors Age Glaucoma can affect people of all ages, but it’s most common in those in their 70s and 80s. As we age, the optic nerve gradually loses nerve cells, and glaucoma accelerates this process. The longer we live, the greater the risk of developing glaucoma. Ethnic Origin People of African or Caribbean descent are at higher risk of developing glaucoma, often at a younger age and with more severe disease. This risk increases significantly after age 40. Family History of Glaucoma Glaucoma, particularly primary open angle glaucoma and primary angle closure glaucoma, often runs in families. If you have a close relative with glaucoma, your risk of developing the disease is four to nine times higher than average. If you have been diagnosed with glaucoma your direct relatives should have regular eye tests, and are entitled to free NHS eye checks if they are aged 40 or older. Myopia (Short-Sightedness) Moderate to high short-sightedness increases the risk of developing certain types of glaucoma, especially pigmentary glaucoma and primary open angle glaucoma. Hypermetropia (Long-Sightedness) Long-sightedness can lead to primary angle closure glaucoma, as these eyes are often smaller, which can crowd the drainage system and lead to increased pressure. Implications for Your Family Glaucoma is often a painless condition that damages the outer edges of vision first, gradually working its way inwards. Because it progresses silently, many people don’t realise they have it until it’s advanced. Early detection through regular sight tests with an optician is crucial. While everyone should have an eye test every two years, those with a close relative (parent, sibling, or child) with glaucoma should be tested more frequently. In the UK, people over 40 with a first-degree relative who has glaucoma are eligible for free sight tests every two years. Bigger picture Risk factors Diet and lifestyle for family MORE ABOUT UNDERSTANDING GLAUCOMA AVAILABLE TREATMENTS CONTACT TO BOOK