Glaucoma

What is Glaucoma?

Primarily Increase in intraocular pressure (IOP) along with damage to the optic nerve and decreased field of vision is termed as Glaucoma.

In patients of Glaucoma peripheral vision gets affected first followed by central vision. This situation leads to delay in recognizing early glaucoma and patient may not recognize it in initial stage. Thus, Glaucoma is termed as silent killer of Vision. Glaucoma results in irreversible loss of vision, if not treated properly. With early diagnosis and precise management, doctors & patient together can definitely beat this dangerous disease of eye-glaucoma.

Types of Glaucoma

Congenital glaucoma (In newborn babies).
Primary glaucoma.
Open angle glaucoma.
Closed angle glaucoma.
Secondary glaucoma.
LIG if cataract not operated on time.
Traumatic glaucoma.
Iritis/ Uveitis (Bleeding in eye due to diabetic or hypertensive retinopathy etc.)

Who can have Glaucoma?

Age above 40 yrs.
Can be present at birth also.
Family history of glaucoma.
Drug induced glaucoma.
Injury to eye.
High refractive error.
Diabetes / Hypertension.
Any one apart from above condition.

Symptoms

Eye ball size in case of congenital Glaucoma (in new born babies) are larger than normal (either one or both). Hazy Eye (particularly in infants)
Difficulty in looking at illuminated objective termed as Photophobia.
Seeing circle around light called as Halos.
Family history of glaucoma (Hereditary) Diabetes/Hypertension.
Redness, Pain, Decreased Vision.
Sometimes totally symptomless

Diagnosis

Following tests are performed for diagnosis of Glaucoma.

Checking of intra ocular pressure (IOP) – Normal 12 To 20mm of Hg.
Examination of anterior segment and optic nerve.
Gonioscopy
Pachymetry
Field of vision
OCT

SLIT LAMP EXAMINATION -

Anterior Segment
Optic nerve examination

PERIMETRY

Most advanced & standardized HFA perimetry for field testing which is confirmatory test for glaucoma.

HFA II

OCT-OPTICAL COHERENCE TOMOGRAPHY

To study op nerve for any possibility of glaucoma

PACHYMETRY

To measure thickness of cornea

Treatment

Medical Management: To reduce intra ocular pressure.

Laser treatment: In angle closure Glaucoma YAG laser treatment is required, for which we are equipped with Nd YAG -laser machine

Surgical Treatment: Surgical treatment is required in advanced Glaucoma or in condition when IOP is not controlled with medicine. (e.g., Trab, Trab+Trab for congenital Glaucoma, etc.)

Important

Early diagnosis of Glaucoma is very important.
The damaged caused by Glaucoma cannot be reserved back & we can save patient’s existing vision.
Patient need to continue recommended medical treatment for longer duration or sometimes lifelong.
Regular follow-up even after IOP is in control is required for early detection of change in medical treatment or requirement of surgery.