Glaucoma describes a whole group of diseases affecting the eye, but all share the common fact that they cause the pressure within the eye (intraocular pressure) to increase to unhealthy levels in the affected person. Most types of glaucoma are chronic and are present for the patients lifetime. Some types of glaucoma occur suddenly, but most develop slowly, over months or years. Appropriate treatment for glaucoma will prevent loss of sight in majority of patients whose condition is detected early.
In normal eyes a clear transparent fluid called Aqueous humor is secreted inside the eye and continuously drained via microscopic outflow channels into the blood circulation. If this outflow of fluid is blocked due to any reason, the pressure inside the eye builds up and causes damage to the eye. Glaucoma is a spectrum of diseases where the optic nerve is damaged most commonly due to increase in intraocular pressure.
The normal human eye functions like a camera. When we look at any object the image falls on the neurosensory retina and is carried to the brain via the optic nerve. The optic nerve is like an electrical cable with more than a million wires. Increase in intraocular pressure damages these wires (optic nerve fibers) causing their death, resulting in blind spots in the field of vision. When the disease is advanced, it can cause total blindness.
Glaucoma can be divided into many types depending on the mechanism:
Symptoms vary according to the type of Glaucoma.
Chronic simple glaucoma/open angle glaucoma
Acute closed angle glaucoma
In certain individuals the angle from where the fluid from inside drains out is narrow and can get blocked resulting in sudden increase in pressure, giving rise to symptoms like
When increase in pressure occurs due to some other disease in the eyes like inflammation, tumor, hyper mature cataract, bleeding trauma, use of corticosteroids etc., then it is known as secondary glaucoma.
This type of glaucoma is present from birth and it occurs due to abnormal drainage channels in the eye. Congenital glaucoma has the following symptoms:
Glaucoma can be diagnosed with routine examination or when a patient visits the doctor for the above described symptoms. Diagnosis is confirmed by
The treatment option depends upon the type of glaucoma, extent of damage, effectiveness of medical treatment, patients compliance, etc. Various treatment options can be:
Your doctor will call you for periodic check ups to do a detailed glaucoma evaluation which includes intraocular pressure, fields, nerve evaluation, etc., to pick any progression. The treatment is adjusted according to the results.
Surgery comes with its own effectivity (90%), side effects and complications. Moreover, many times even after surgery you may need to use medication. Your doctor will be the best judge to advise you about your options.
Often patients go to the doctor very late, when excessive damage to optic nerve has already happened. That is why routine examination is emphasized in people over the age of 40 years. In such a scenario, further damage to the optic nerve can only be stopped by medication. Whatever damage/ death of optic nerve fibers have occurred can not be reversed. If glaucoma is not treated in time it keeps constricting visual fields leading to a very small central island of vision and eventual blindness.
Glaucoma is a disease which damages the optic nerve (the nerve for vision) due to increased eye pressure. In the beginning stage, there are hardly any symptoms. Many times glaucoma is diagnosed only on routine examination. Once diagnosed it needs proper follow-up to see if nerve is getting further damaged (by field test, OCT etc). According to your specific care – treatment is tailored. Even surgery is not one shot Cure, you will still require to follow-up with doctor.
Glaucoma is responsible for 12.3 per cent of treatable blindness and the incidence increases with increasing age. In glaucoma, we definitely believe prevention is better than cure. Hence routine check-up at 40 years of age is advised for all.
Extra care is required if there is family history of glaucoma.
Hence we run a special Glaucoma Clinic every Wednesday from 1 pm to 5 pm
We have best equipments for glaucoma diagnosis like Humpherys Perimeter for checking field of vision, and Spectral Domain HD – OCT for checking the Vision nerve (Optic Nerve) both from Carl Zeiss Company, Germany.