What is Glaucoma?
Glaucoma (kaala motiya) is a spectrum of conditions in which the optic nerve undergoes damage because of increased pressure within the eye leading to a fall in visual acuity and limitation of visual fields. Glaucoma impacts anywhere between 2 to 3 million people and is the second most common reason for visual loss, after cataract. In glaucoma, the pressure inside eye (intraocular pressure/IOP) rises bit by bit, debilitating the optic nerve. The eye’s trabecular meshwork , through which fluid of the eye drains, is either physically blocked or is malformed leading to build up of fluid The optic nerve is in charge of vision, as it carries the light signal received by retinal photoreceptors, to the brain. In this way once it is damaged beyond a certain extent, it can lead to loss of visual field, central vision and even total blindness (all out visual impairment). Most people with glaucoma have no early symptoms or specific complaints. That is why most patients are diagnosed late (as they approach the doctor in advanced stage) and if patients are not taking regular medicines, are not aware of further worsening. Visual loss due to glaucoma cannot be regained, but early diagnosis and management can halt progression and preserve very good vision till late. You have to see your eye specialist regularly so they can analyse and treat glaucoma.
Cause of Glaucoma!
Ordinarily, the liquid, called Aqueous Humor, streams out of the eye through a sieve like channel. On the off chance that this channel drainage gets hindered, the fluid accumulates. The explanation behind the blockage is obscure, yet specialists do realize that it may very well be acquired, which means it is passed from guardians to youngsters. The imbalance between the drained and formed aqueous , prompts the rise in pressure and a steady harm to the optic nerve.
Symptoms of Glaucoma
Most cases of glaucoma are asymptomatic and hence frequent check ups with an ophthalmologist is Key
- Halos or rainbows around light
- Redness of the eye
- Abnormal increment in the eye pressure measurement values
- Decreased vision
- Loss of fields ie, unable to see objects in the extremes of gazes, until object comes straight in front/center.
- Nausea and vomiting in sudden rise of pressure.
- Blind spots in the fields of vision of involved eyes
- Tunnel vision
- Complete visual impairment
Types of Glaucoma
A. Congenital Glaucoma- present since birth
B. Juvenile Glaucoma- develops later in childhood
C. Open Angle Glaucoma with sub types
D. Closed Angle Glaucoma with subtypes
E. Secondary Glaucomas like:
- Post traumatic- blunt trauma to eye
- Certain syndromes where the structures of eye are not formed properly
- Post blockage of blood vessels in retina ( as in Diabetics, Hypertensives, coagulopathies)
- Due to some medications also (like excessive use of steroids
Management Of Glaucoma
Glaucoma is an eye condition which when diagnosed, the patient needs to follow up regularly and requires lifelong therapy.To get Best Glaucoma Care choose the best eye care center. Hence, a proper diagnosis is important before labelling a patient so:
Nowadays there are latest investigations which can supplement a clinician’s acumen of diagnosing Glaucoma using slit lamp biomicroscopy / direct ophthalmoscopy, gonioscpoy and Tonometry. Infact these tests can also help in detecting glaucomatous damage at an early stage, even before it is visible to naked eye.
- Optical Coherence Tomography (OCT) Glaucoma for RNFL and GCC analysis.
- Humphrey Visual Field ( for both diagnosis, progression analysis and prognosis)
- Clinical Disc Photography
- Most patients are easily managed on Topical Drops which help in controlling the eye pressure for long. There are multiple drugs now available in our armamentarium to control eye pressure, depending on the variety / severity of glaucoma.
- Laser procedures like gonioplasty, iridoplasty, YAG Peripheral Iridotomy, Trabeculoplasty
- MIGS (minimally invasive glaucoma surgery)
- Surgical Procedures like trabeculotomy/trabeculectomy, valved devices, if patient is uncontrolled on medications.
- Laser cyclophotocoagulation, Cyclocryotherapy