Glaucoma Clinic

What is Glaucoma?

Glaucoma is a disease of the optic nerve head caused by the increase of fluid pressure in the eye. It is a disease that gradually steals sight without warning and often without any symptoms. Glaucoma is a progressive disease, how ever by its early detection and treatment one can slow the progression of disease and often protect the eyes against serious vision loss.

How does it happen?

The fluid is constantly secreted into the eye is constantly drained out of the eye. This maintains a constant intraocular pressure. When this circulation gets blocked fluid starts accumulating in the eye. As the fluid builds up it begins to exert pressure inside the eye and damages structures vital for vision like optic nerve head as shown.

Incidence and Prevalence of Disease

The Glaucoma is the third leading cause of blindness worldwide. Its estimated that up to 70 million people have Glaucoma and that 6.7 million experience bilateral from this disease.

Who are the people at risk for glaucoma?

  • People over 60 years of age.
  • Black races commoner that whites.
  • Family history of Glaucoma especially in first degree relatives.
  • Myopes and hypermetropes people.
  • Diabetics and hypertensives.
  • People with history of steroid use or history of eye injury.

Types of Glaucoma

1. Open angle Glaucoma: More common form incidence 1 in 100 after 40 years.

2. Angle closure Glaucoma: Incidence 1 in 1000 after 40 years, is an acute onset Glaucoma with sudden increase in he IOP with pain in the affected eye headache and vomiting. This needs an emergency treatment.

What are the symptoms of open angle Glaucoma?

At first open angle Glaucoma has not symptoms. It causes no pain. Vision stays normal. Without treatment people will slowly lose their peripheral vision. Over a period of time, straight ahead vision may also decrease until no vision remains.

If I have increased eye pressure does that mean that I have Glaucoma?

No. Not every person with increased pressure will develop Glaucoma. Whether you develop Glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged. This level is different for each person. That's why not just the eye pressure but a comprehensive dilated eye examination is very important.

Comprehensive Eye Examination

At Rajan Eye care Hospital, we have a full fledged glaucoma clinic with sophisticated equipment. As a part of the routine eye examination, IOP is checked for all the patients using the applanation tonometer which is the most accurate. For patients suspected to have glaucoma, or high risk group patients with family history of glaucoma, the following tests are to be done:

Visual acuity test:

This eye chart test measures how well you see at various distances.

Visual field test:

This test measures your side vision. It helps your eye care professional tell if u have lost side vision, a sign of Glaucoma.

Tonometry:

An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Gonioscopy:

Study of angle of eye with goniolenses like zeiss four mirror and goldmann three mirror and single mirror.

Ophthalmology:

with direct indirect non contact +78D +90D/ GDX analyzer to study optic nerve head and nerve fiber layer.

Treatment

  • Medical treatment: in the form of eye drop or pills is the most common early treatment for glaucoma, it is very important to use the drops regularly as prescribed.
  • Nd- YAG laser indotomy and trabeculoplasty: is an outpatient procedure which is especially useful in narrow angles and angle closure glaucoma.
  • Conventional surgery: indicated a\in advance or moderately advanced cases which are not controlled by medication or laser. This is a microsurgical procedure with good results.