GLAUCOMA

Glaucoma is a group of disorders in which, fluid pressure within the eye increases to a level, causing irreversible damage to the vision (optic) nerve that connects the eye to the brain to transmit visual images. Damage to the optic nerve results in irreversible blindness if left untreated.

There are two major types of glaucoma:

​I) Primary Open Angle Glaucoma (POAG) - This is the most common type of glaucoma and mostly asymptomatic. The damage occurs gradually.

II) Primary Angle Closure Glaucoma (PACG) - This type with hallow or closed angles of anterior chamber sometimes present with sudden onset of red and painful eyes and would lead to blindness if not treated immediately.

Congenital Glaucoma is known to occur in children born with malformations in the angle of the eye. It can be detected by symptoms such as large cloudy eyes, severe sensitivity to light and excessive tearing or watery eyes.

Glaucoma is often referred to as the 'sneak thief of sight' as it can strike without any symptoms. However, some glaucoma patients may suffer symptoms like:

1. ​Severe eye pain in case of angle closure glaucoma
2. Blurred vision
3. Seeing coloured halos around lights
4. Frequent change of reading glasses

Everyone is at a risk of getting affected by eye disease, Glaucoma. But certain risk factors for the disease are:

1. ​High Intraocular pressure
2. Age - Risk increases with age, especially those beyond 40 years of age
3. Heredity - Primary Open Angle Glaucoma affects those with a family history of glaucoma (13%)
4. Ethnicity - Glaucoma is common among Asians, Africans- Americans and Hispanics
5. Sustained eye injury - In such cases, glaucoma can occur immediately after the injury or even in later years
6. High myopia (nearsightedness)
7. Diabetes
8. Hypertension
9. ​Steroids intake

Periodical eye check-ups are the best way to detect Glaucoma easily. Glaucoma can be detected using five basic tests, they are:

1. Visual acuity test
2. Tonometry, to measure the eye pressure
3. Gonioscopy, to assess angles of anterior chamber
4. Evaluation of optic disc damage
5. Perimetry test, for visual field examination
6. Retinal nerve fibre layer analysis

Glaucoma cannot be cured, but it can be controlled. Aim of treatment is to reduce eye pressure using eye drops and medicines. In few, laser treatment is given to open up the drainage area for the fluid. In much severe cases, conventional surgery is performed to create a new drainage path. For congenital glaucoma, surgery is recommended because the effects of eye drops in infants are unknown.

​Things to remember about Glaucoma

1. Glaucoma, like diabetes, cannot be cured, only controlled
2. ​Vision lost due to glaucoma cannot be recovered
3. Early detection and treatment of glaucoma will prevent further loss of sight and blindness
4. It is essential that people above the age of 40 and those with a family history of glaucoma have their eyes examined periodically to detect glaucoma early
5. Once diagnosed as having glaucoma, the patient should be committed for lifelong treatment and periodical eye check-up
6. ​Drugs prescribed by the doctor should be regularly used at the specified time, to ensure round-the-clock pressure control

Topical non-pad Glaucoma operation (Trabeculotomy) .

1. Visual Field Examination by Automated Perimter (OPTO Australia).
2. Eye pressure examination by Non-contact Tonometer (TOPCON U.S.A) .
3. Retinal Nerve Fiber Analysis by OCT.
4. Retinal Photograph for C:D Ratio.
5. Gonioscopy
6. Laser Trabeculoplasty by Argon