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Glaucoma also known as kala motia refers
to a group of eye conditions that lead to
damage to the optic nerve, the nerve that
carries visual information from the eye
to the brain. In many cases, damage to the
optic nerve is due to increased pressure
in the eye, also known as intraocular pressure
(IOP).
The eye produces a fluid known as aqueous
humor that nourishes the cornea and the
lens. The aqueous humor is continually produced
by the ciliary body and drains through mesh
like channels located in the trabecular
spaces of the angle of the eye. In a normal
eye the rate of production should be balanced
by an equal rate of drainage.
This keeps the pressure inside the eye (intraocular
pressure) stable. In some individuals, with
advancing age, these channels get blocked;
disrupting the outflow of this fluid. Anything
that slows or blocks the flow of this fluid
out of the eye will cause pressure to build
up in the eye. This results in raised pressure
within the eye. This raised pressure then
starts damaging the optic nerve. Damage
caused to the Optic Nerve leads to decrease
in the field of vision and sight. Glaucoma
causes irreversible damage to ones eye.
Without treatment, glaucoma can cause total
permanent blindness within a few years.
Glaucoma is not curable but treatable. It
can be controlled and further damage to
the optic nerve can be slowed down or halted.
This control can only be sustained through
very disciplined and regular treatment as
advised by a glaucoma specialist. It is
a lifelong process |
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What Are the Types of Glaucoma?
There are four major types of glaucoma:
- Open-angle (chronic) glaucoma
sub divided as primary open
angle glaucoma and normal tension
glaucoma.
- Angle-closure (acute) glaucoma
- Congenital glaucoma
- Secondary glaucoma
Primary Open Angle or Chronic Glaucoma: This is the most common
form of glaucoma. There is gradual
painless loss of vision. The affected
person might not develop significant
symptoms and may be entirely unaware
of this disease until the optic
nerve has been severely damaged.
Normal Tension Glaucoma:
A special type of glaucoma where
even at lower intraocular pressure
there may be damage to the optic
nerve due to factors such as decreased
blood flow into the eye.
Closed Angle or Acute Glaucoma:
In this type of glaucoma, the intraocular
pressure increases very rapidly
due to a sudden and severe block
of fluid drainage within the eye.
Significant symptoms such as pain,
haloes, headache and decreased vision
may develop.
Congenital glaucoma often
runs in families (is hereditary).
- It is present at birth
- It results from the abnormal
development of the fluid outflow
channels in the eye
Secondary glaucoma is caused
by:
- Drugs such as corticosteroids
- Eye diseases such as uveitis
- Systemic diseases
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What are the symptoms of Glaucoma?
Open-Angle Glaucoma
- Most people have NO symptoms
until they begin to lose vision
- Gradual loss of peripheral
(side) vision (also called tunnel
vision)
Angle-Closure Glaucoma
- Symptoms may come and go
at first, or steadily become
worse
- Sudden, severe pain in one
eye
- Decreased or cloudy vision
- Nausea and vomiting
- Rainbow-like halos around
lights
- Red eye
- Eye feels swollen
Congenital Glaucoma
- Symptoms are usually noticed
when the child is a few months
old
- Cloudiness of the front
of the eye
- Red eye
- Sensitivity to light
- Tearing
- Squint
If you have any of the following
symptoms, seek immediate medical
care:
- Seeing halos around lights
- Vision loss
- Redness in the eye
- Eye that looks hazy (particularly
in infants)
- Nausea or vomiting
- Pain in the eye
- Narrowing of vision (tunnel
vision)
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Who Gets Glaucoma?
Glaucoma most often occurs in
adults over age 40, but it can also
occur in young adults, children,
and even infants. In African-Americans,
glaucoma occurs more frequently
and at an earlier age and with greater
loss of vision.
You are at an increased risk
of glaucoma if you:
- Are of African-American,
Irish, Russian, Japanese, Hispanic,
Inuit, or Scandinavian descent.
- Are over age 40.
- Have a family history of
glaucoma.
- Have poor vision.
- Have diabetes or hypertension
- Take systemic corticosteroid
medications, such as prednisolone.
- Have undergone any kind
of eye surgery.
- Have thyroid gland related
ailments.
Have over - mature cataracts.
Have had any injury to the eye.
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How Is Glaucoma Diagnosed?
The common features to most types of glaucoma
are:
- Increased intraocular pressure:
This is measured with Goldmann Applanation
Tonometer. This instrument is pressed
against the patient's eye to determine
the intra-ocular pressure.
- Cupping or Atrophy of the Optic
Nerve This is a measure of loss
of the nerve fibre layer of the optic
nerve due to damage caused by the raised
pressure in the eye. This is assessed
by examination of the fundus. Newer
imaging modalities like the optical
coherence tomography (OCT), GDx, HRT
are now available for measuring the
status of the nerve fibre layer and
documenting the extent and progression
of the damage.
- Visual Field Defects: The
visual field is assessed by an instrument
called the Perimeter.
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What are the tests for glaucoma?
- Tonometry: Recording of pressure
is done using Goldmann Applanation Tonometer.
- Gonioscopy: A lens is applied
on the eye and angle is examined to
see if it is open or closed type of
glaucoma.
- Perimetry: This test is essential
not only to assess the extent of the
existing damage, but also to document
and measure the progression of the disease
and the response to treatment.
- New sophisticated tests:
OCT (Ocular Coherence Tomography), CCT
(pachymetry), GDx, ORA, HRT etc.
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How Is Glaucoma Treated?
Primary objective of the treatment is to
reduce the intraocular pressure. Depending
upon the type of glaucoma, this is achieved
by medications or by surgery. Usually eye
drops that reduce the intraocular pressure
are prescribed. Medications may also be
given orally or intravenously. Side effects
of glaucoma drops may include allergy, redness
of the eyes, brief stinging, blurred vision,
and irritated eyes. Some glaucoma drugs
may affect the heart and lungs. Be sure
to tell your doctor about any glaucoma medication
you are currently taking or are allergic
to. Few laser procedures that can be done
include trabeculoplasty, in which a laser
is used to pull open the trabecular meshwork
drainage area; iridotomy, in which a tiny
hole is made in the iris, allowing the fluid
to flow more freely; and cyclophotocoagulation,
in which a laser beam treats areas of the
ciliary body, reducing the production of
fluid. A surgery called Trabeculectomy is
performed to control glaucoma. In this technique
a new drainage channel is created for the
fluid to exit, thus lowering the pressure
build up. These drops reduce the. |
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Can glaucoma be prevented?
Glaucoma cannot be prevented, but if it
is diagnosed and treated early, the disease
can be controlled.
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What Is the Outlook for People With Glaucoma?
At this time, loss of vision caused by glaucoma
is irreversible and cannot be restored.
However, successfully lowering eye pressure
can prevent further visual loss from glaucoma.
Most people with glaucoma do not go blind
as long as they follow their treatment plan
and have regular eye exams.
Important facts about Glaucoma
- There is no prevention for the development
of glaucoma.
- Sometimes the symptoms of glaucoma
are simply not noticeable.
- Glaucoma can silently snatch away
your vision.
- Timely detection of glaucoma is
a must.
- Timely treatment of glaucoma may
prevent further loss of vision and blindness.
GLAUCOMA SERVICES
Our centre is equipped with latest machines
for diagnosis and treatment of glaucoma:
- Field Analyser
- GDX
- Non Contact Tonometer
- Gonioscopy Lenses
- ND-Yag Laser
- Cirrus OCT
- Visante OCT
- ORA
Early diagnosis is the key to prevention
of severe vision loss in glaucoma patients
and the new tools like OCT, ORA, Pachymetry,
GDX at our centre helps us pick the glaucoma
patients at very early stage, even when
vision loss or other symptoms have not appeared.
These examinations assist our extremely
trained doctors to help you win this notorious
eye disorder also.
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