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G L A U C O M A
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What is Glaucoma ?
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Glaucoma is group of eye diseases in which the pressure of fluid within the eye gradually increases to a level not tolerated by the sensitive tissues of the eye. The optic nerve, which is similar to a cable wire carrying visual images to the brain, is the portion of the eye susceptible to damage from glaucoma. Such damage is irreparable resulting in permanent loss of vision and complete blindness. Rarely, a weakly structured optic nerve or poor blood circulation in the back of the eye can also cause glaucoma like damage to the optic nerve, even if eye pressures are normal.
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What causes Glaucoma ?
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There is fluid filled chamber in the front of the eye called the anterior chamber. It is filled with aqueous humour, which bathes and nourishes the tissues of the eye. For reasons, yet unknown, if the drainage of this fluid out of the eye is restricted, pressure builds up within the eye. Unless this pressure is controlled by appropriate treatment it causes irreversible damage to the optic nerve and other parts of the eye and causes loss of vision that is permanent.
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Who is likely to get Glaucoma ?
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Glaucoma is one of the leading causes of blindness in India. Based on various population sample studies, about 2 persent of the general population can have one form of glaucoma or the other. It can affect all sections of the society, irrespective of caste, creed, age, ses, cultural or socio economic factors. Although older individuals over the age of 40 are more likely to have glaucoma, people of all age groups including children should have periodical evaluation by an opthalmologist to exclude glaucoma. Individuals with myopia, diabetes, systemic hypertension and family history of glaucoma have an increased risk. As glaucoma is known to be hereditary all adults in the family should have regular eye checkup. A simple test by an eye doctor, which measures the ocular pressure and dilated eye examination is sufficient to screen people for glaucoma.
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What are the symptoms of Glaucoma ?
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Most types of glaucoma could cause singnificant visual loss without any symptoms. Hense, a periodical eye checkup of all individuals is desirable to exclude the possibility of glaucoma. Until advanced, vision stays normal and there is no pain or redness of the eye. However, if glaucoma progresse without adequate treatment, side vision beings to gradually fail.
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Though objects in front are still seen clearly, those to the side may be missed. The individual with advanced glaucoma is still able to read clearly, but often bumps into objects to his side. Vision in dim illumination fials. Adaptation of vision in dark is also delayed. Some forms of acute glaucoma, however can cause pain, redness, decrease in vision and colored halo rings around bulbs.
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How is Glaucoma detected ?
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A simple test with a device called tonometer measures pressure within the eye. This is performed after applying local anaesthesic eye drops that numb the eye. It does not cause pain or irritation. The test alone cannot detect all glaucomas. The back of the eye should be inspected to view the optic nerve after dilating the pupils. The side vision may also be examined by a computer assisted, simple test called perimetry (visual field examination). Another test called gonioscopy is useful to identify the type of glaucoma.
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How is Glaucoma treated ?
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Glaucoma cannot be cured. The loss of vision that already exists cannot be recovered. However, appropriate treatment and regular follow up can preserve residual vision from further damage. Earlier the diagnosis, better is the chances of arresting the progression of glaucoma.
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Medications :
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Several drugs are available to arrest the excess fluid formation within the eye or promote their drainage from the eye. For most people with glaucoma, regular use of medications will control the increased fluid pressure. However, in some, drugs may stop working over time.
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In these situations, the eye doctor can help by adding or changing medications or by choosing another type of treatment : lase or operative methods. Periodical eye examination is therefore essenitial to check if medications are working.
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Laser treatment
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In some type of glaucoma, called angle closure glaucomas, laser treatment is the primary form of reducing the eye presure. This is simple outpatient procedure, which uses a strong beam of light to relieve the fluid pressure.
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In open angle type glaucoma, laser treatment is applied only if various medications fail to control the fluid pressure. Medications need to be continued regularly even after laser treatment.
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Laser treatment has very minimal complications, but its effect in reducing the eye pressure may wear off over time.
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Surgery
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In some presons with glaucoma, medical or laser treatment is insufficient to arrest glaucoma and surgery is indicated. But this treatment option has its risks and limitations and is reserved as treatment of last resort. Even after surgical treatment, individuals with glaucoma should have periodical check up by an eye doctor.
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Remember :
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Early detection and treatment of glaucoma before it causes major visual loss is the ideal way to control the disease.
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Once diagnosed, patient should be committed for life-long treatment and periodical eye check-up.
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Drugs prescribed should be regularly used at specified time, to ensure round the clock presure control.
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Periodical evaluation and advice by an eye doctor is essential to check progression of glaucoma.
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01. Diabetes and the Eye
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02. Refractive Errors in Children
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03. IOL Implantation in Children
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04. Treat amblyopia early & save sight
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05. GLAUCOMA
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06. PHACOEMULSIFICATION (PHACO)
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