Glaucoma is described as progressive optic atrophy leading to gradual loss of vision due to multiple factors. Intra Ocular Pressure (IOP), is one of the factors that affect the functioning of the optic nerve.
Glaucoma Services
What is Glaucoma?
Glaucoma is Mainly divided into two groups
Congenital Glaucoma: This is seen in newborn infants. It is due to a developmental defect of draining channels and the front portion of the eyeball. It is a serious sight-threatening problem. If diagnosed in an early stage, can be treated by surgery.
Acquired Glaucoma: Again it can be classified as:
- Primary Glaucoma: Which occurs without any underlying cause. It is due to the age and changes in anatomical configuration. It can be again classified as:
- Open-angle Glaucoma: This usually occurs in people above 40 years. Though the drainage area is open, the draining channels are blocked due to age-related changes.
- Narrow-angle Glaucoma: The iridocorneal angle is narrow which causes obstruction to the outflow of fluid in the eyeball. This increases the intraocular pressure which in turn hampers the optic nerve functioning.
- Secondary Glaucoma is due to the underlying causes like injury, inflammation, diabetes etc.
People at Risk:
- Having refractive errors.
- With a family history of Glaucoma.
- With a history of eye injuries.
- Using steroid eye drops.
- Diabetics and hypertensives.
Points to Remember:
- A sneak thief of sight since no symptoms will be observed.
- Regular screening after 40 years of age is a must.
- It runs in the family.
- Glaucoma cannot be cured but can be maintained with regular follow-ups and medication.
- Glaucomatous optic nerve damage is irreversible.
- Glaucoma treatment is a lifetime commitment.
- Diagnosis is based on the reports of Intraocular Pressure (IOP) measurement, Visual field test, Optic nerve head examination and Gonioscopy.
- Early diagnosis and treatment will save the vision.
Glaucoma clinic is equipped with
Tonometers – Applanation, NCT, Tono Pen: To measure IOP
Slit lamp examination and Gonioscopy: To assess the drainage area of the eye (angle of the anterior chamber)
Automated perimeter: to evaluate the visual field defect which indicates the extent of optic nerve damage.
VFT
Glaucomatous Field Defects
Visual Field Analyser
OCT: It is a scanning device where the structural integrity of optic nerve and retina is evaluated in relation to Glaucoma.
OCT image showing thickness of the Nerve Fiber Layer
Optical Coherence Tomography Machine
Treatment
Treatment depends on the type and stage of Glaucoma. Most of the time it is the medical line of treatment. Eye drops will be used to lower and maintain IOP and as neuroprotectors. Other treatments include
- Surgical: Filtering Surgery ( Trabeculectomy).
- YAG laser procedure: To perform Yag laser Iridotomy in narrow-angle Glaucoma.
- Argon laser trabeculoplasty and gonio-photocoagulation as a palliative treatment in Glaucoma.
- Cylcocryopexy: is a destructive procedure to freeze the ciliary body and to reduce the aqueous humour production thereby reducing the IOP in painful blind eyes.
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