Glaucoma Assessment and Management

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WHAT IS GLAUCOMA

Glaucoma is a serious eye disease often called “the silent thief of sight” as it affects unsuspecting people and robs them of their eye sight. Many people affected with the disease do not realise they have the condition. This is because the disease is slow, insidious and affects the eyes unequally. Persons affected often carry on living normal lives whilst the disease destroys the nerves of their eyes. The tragedy is that there is no treatment to recover that part of the eyesight which is lost and if there is no timely detection and intervention, it can lead to irreversible blindness. It is not an uncommon disease. Glaucoma is the third leading cause of blindness in India and 12 million people are affected accounting for 12.8% of the blindness in our country.

WHAT CAUSES GLAUCOMA

The exact cause of glaucoma is not known. It is usually but not always, associated with a rise in the pressures within the eye.

SYMPTOMS OF GLAUCOMS

There is two main types of glaucoma — open-angle glaucoma and narrow angle glaucoma. Both have completely different symptoms.

A. Primary open-angle glaucoma signs and symptoms include:

  1. Gradual loss of peripheral vision, usually in both eyes
  2. Tunnel vision in the advanced stages

B. Acute angle-closure glaucoma signs and symptoms include:

  1. Severe eye pain
  2. Nausea and vomiting (accompanying the severe eye pain)
  3. Sudden onset of visual disturbance, often in low light
  4. Blurred vision
  5. Halos around lights
  6. Reddening of the eye

WHO CAN DEVELOP GLAUCOMA

  1. Glaucoma can affect any age group, including new-born, infants, children and elderly
  2. Certain individuals have a greater risk of developing glaucoma and these persons should be regularly checked for glaucoma. This will help in early detection and help preserve vision in glaucoma individuals at risk -
  3. Age over 40 years of age
  4. Glaucoma in the family
  5. Those with diabetes
  6. High minus power or plus power over 4
  7. have received steroid containing preparations : tablets/ drops/ ointments/ puffs/ injections

TESTS FOR GLAUCOMA

When the condition is suspected certain tests are carried to confirm the diagnosis, determine the type of glaucoma and the extent of eye damage.

  1. The visual field is examined for loss
  2. The eye nerves are scanned for damage
  3. The thickness of the cornea is measured The tests help the doctor choose the appropriate therapy

TREATMENT

Glaucoma can be treated by medicines, laser surgery or by filtering surgery.

  1. Medicines are given usually in the form of eye drops. Glaucoma cannot be cured and treatment can only arrest the damage caused by the disease. Thus the eye drops have to be applied daily for the rest of the individual’s lifetime.
  2. Laser Therapy is used to treat an acute form of glaucoma called narrow angle Glaucoma
  3. Sometimes the above measures fail to arrest the progress of the disease and surgery has to be done. The operation commonly done is Trabeculectomy.

FACILITIES AVAILABLE

Poorva Eye Care is equipped with world class equipment and experienced glaucoma specialists for early diagnosis and proper treatment of glaucoma. They include:

  1. Goldman application tonometer considered gold Standard) for accurate measurement of eye pressure.
  2. Three and four mirror goniolens for detecting the type of glaucoma
  3. Humphrey Perimeter to examine the visual field which is slowly destroyed by glaucoma
  4. Ultrasonic Pachymeter for accurate measurement of central corneal thickness
  5. Scanning of the optic nerve with OCT for imaging, diagnosing and monitoring the optic nerve and retinal nerve fibre layer
  6. Zeiss Nd YAG Laser for treating a common type of glaucoma called angle closure glaucoma which is associated with sudden and severe rise of eye pressure leading to poor vision.
  7. Glaucoma Filtration Surgery