Glaucoma

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What Is Glaucoma?

Glaucoma, the silent thief of sight is a term used to describe a group of diseases of the eye characterized by progressive and irreversible damage to the optic nerve (nerve of the eye responsible for vision) and which if untreated can lead to blindness. Though raised pressure of the eye (pressure maintained by fluid in the eye) is an important risk factor, a few individuals can develop glaucoma even with normal pressure of the eye.

Are You At Risk For Glaucoma?

If You Answer Yes To Any Of These Questions Below, Then You Are At High Risk:

Is your age 45 and above?

yes no

Do you have a family member having gluacoma?

yes no

Do you use steroid oral/pump?

yes no

Have you ever had an eye injury or trauma?

yes no

Do you wear thick glasses?

yes no

Do you take treatment for diabetes/hypertension?

yes no

Prevalence

  • Due to its asymptomatic nature and subtle clinical signs, a significant proportion of Glaucoma remains undetected in people worldwide.
  • As on date, the global prevalence of glaucoma is 64.3 million which is predicted to increase by 18% in 2020 and 74% in 2040, predominantly affecting the inhabitants from Asian and African ethnicity. Women comprise more than 50% of all cases.
  • More than 12 million people in India have Glaucoma – but only half know they have it.
  • 25% of Glaucoma patients present to eye surgeon when one eye vision is lost and 8-10% people know about the disease when 80% nerve fibers are lost.

Symptoms

The most common type of glaucoma (open-angle glaucoma) often has no symptoms rather than slow vision loss. Angle-closure glaucoma although rare is a medical emergency and its symptoms include eye pain with nausea and sudden visual disturbance.

  • Inability to adjust the eyes to darkened rooms, such as theaters
  • Poor night vision
  • Frequent changes in eye glass prescription
  • Gradual loss of peripheral vision
  • Blurred vision
  • Feeling of a blind area in the eye
  • Seeing rainbow colored halos around lights
  • Severe eye pain, facial pain, nausea and vomiting
  • Red eye

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Chronic Or Primary Open-Angle Glaucoma (POAG)
  • The chronic open-angle form of glaucoma is the most common form. Damage to vision is gradual and generally painless.
Closed Or Acute Angle – Closure Glaucoma
  • In the closed or acute form, the intraocular pressure increases rapidly due to a sudden and severe block of fluid drainage within the eye. Significant symptoms indicating the presence of acute glaucoma appear immediately. This condition has to be treated quickly by an ophthalmologist otherwise blindness may occur.
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Tonometry
  • Inner eye pressure (IOP)
Ophthalmoscopy (Dilated Eye Exam)
  • Shape and colour of the optic nerve
Perimetry (Visual Field Test)
  • Complete field of vision
Gonioscopy
  • Angle in the eye where the iris meets the cornea
Pachymetry
  • Thickness of the cornea
OCT (Ocular Coherence Tomography)
  • Just like CT Scan, enables accurate and reproducible measurements of ONH and RNFL parameters, analyze glaucoma progression
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  • Glaucoma treatment currently falls within three basic categories – medication, incisional surgery and laser treatments. All of these are aimed at lowering intra ocular pressure (IOP) within the eye.
  • While these are effective for most patients, many continue to lose vision through damage to the optic nerve. For them, there is great need for treatments that stop progression independent of IOP.
Eye Drops
  • Eye drops are standard medication option for glaucoma patients. They lower fluid pressure by stimulating the eyes own drainage system or by decreasing the eye’s fluid production.
Laser Light
  • Laser light is used to open drainage channels in the eye.
    • Open – Angle Glaucoma – Laser Treatment Includes
    • Selective laser trabeculoplasty (SLT)
    • Argon laser trabeculoplasty (ALT)
    • Trans-scleral photocoagulation
    Closed – Angle Glaucoma, Laser Treatment Includes
    • Laser iridotomy
    • Peripheral iridoplasty
Surgery
  • Surgery is used to either open the natural drainage channels in the eye, to insert tiny shunts to improve drainage or to remove that part of the eye that is preventing fluid drainage. There are two primary kinds of non-laser surgery
  • Trabeculectomy is the most common kind of surgery and creates a controlled leak of fluid from the eye.
  • Goniotomy is a surgical option for babies and young children with congenital glaucoma, when a special lens is required to see the structure of the inner eye

Frequently Asked Questions

Everyone from babies to elderly people can develop glaucoma. The risk increases after the age of 40

Raised intraocular pressure is a risk factor but those with normal IOP can also have Glaucoma.

Glaucoma is not curable and lost vision cannot be restored. However, further deterioration can be prevented by effective and timely treatment.

Glaucoma is known as the silent thief of sight and is a disease without noticeable symptoms. Patients can progress to advanced stage of glaucoma before they can notice a problem in vision.

Glaucoma can happen without any family history, although it is a risk factor.

Nearly 90% of all Glaucoma related blindness can be preventable with proper treatment and timely diagnosis.

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