GLAUCOMA

Over the recent years, more awareness has been made about eye conditions throughout our state and nation due to social media and general improvement in education. Yet, glaucoma remains to be an enigma which is particularly troubling due to the silent nature in which damage occurs without the patient’s knowledge.

Early diagnosis and management is absolutely vital in the long run as glaucoma, like so many chronic diseases, requires treatment for life-time . Initial stages of glaucoma may be missed if the necessary tools are not available. At Aradhana, we have obtained all the necessary machines in order to make this screening as easy and comprehensive as possible.

The management of glaucoma has come a long way as technology has improved, producing more accurate and reproducible reports. The gold standard test- the HFA field analysis provides time – tested precise results for both diagnosis and prognostication.

OCT- Spectralis with its unique features of confocal scanning laser imaging and ray-tracing technology to strengthen precision is a cut above the rest, giving reliable and reproducible OCT results in glaucoma analysis, enabling your doctor to confidently measure possibility of and extent of disease.

• DIAGNOSTIC TOOLS

  Zeiss HFA, pachymetry, high definition fundus photography, Hiedelberg OCT Spectralis- glaucoma.

• Medical management

  Most glaucoma patients will require medicines for their eyes. Your clinician will advise you on which option is best for your eyes. Regular visits with the doctor is advisable particularly for this disease as patients will not be able to realize if his condition is worsening or improving until severe damage to the optic nerve.

  Remember , glaucoma is not a curable disease but medicines will delay progression if used regularly as per your doctors advise.

• LASER for angle closure glaucoma

  Treatment for one particular type of glaucoma – the angle closure variant- involves making a small hole in the iris to allow fluid inside the eye to get easy access to the outside of the eye. This LASER treatment may cure some patients high eye pressures. Even then, yearly or more frequent reviews may be needed as per individual cases.

• Surgical management- trabeculectomy

  Rarely, surgical treatment may be required for glaucoma management.

• FREQUENTLY ASKED QUESTIONS BY OUR PATIENTS:

  A

  What is glaucoma? Why is it called a “silent killer of vision”?

  Glaucoma is a group of diseases in which there is progressive irreversible optic nerve damage. Primary Open Angle Glaucoma is the most common variant causing progressive optic disc cupping and characteristic field loss. It may affect both eyes simultaneously or one eye first. There are NO symptoms initially and when symptoms occur, usually the disease is advanced. In this disease , like many neuro-degenerative diseases, damaged brain tissue/ nerve tissue does not recover in adults. This is why it is called a silent killer of vision.

  B

  How can I know if I have glaucoma?

  Unfortunately, there are no symptoms or self-tests which are possible for diagnosing this disease. In angle closure glaucoma, there may be pain and eye redness , but angle closure is relatively rare compared to open angle glaucoma. Eye pressure testing is usually not possible without visiting the eye clinic. Home - testing eye pressure tools are extremely expensive and not freely available in India. In addition to this, glaucomatous neuropathy may progress when the eye pressure is totally normal, making diagnosis even more complicated. We advise yearly eye pressure check-up even if you have no eye related problems.

  C

  Is there more than one kind of glaucoma?

  Broadly, there are two kinds of glaucoma- open and closed angle glaucoma. In closed angle glaucoma, there may be symptoms such as pain and headaches. In the more common open angle variant, there are no symptoms until eye pressure reaches more than 50mmHg or so. There are many eye diseases which can cause secondary open or closed angle glaucomas in which part of the treatment would be to treat the root cause.

  D

  How is this disease diagnosed?

  Your doctor will do a thorough examination of your eyes. Once they have done that, some additional tests need to be done- eye pressure measurements at different times of the day, field testing, OCT scan of the nerve fibre, corneal thickness, fundus photography, anterior chamber angle imaging, as the case may present. Not all tests are necessary for all patients. Your doctor would be the best person to advise you on the matter.

  E

  My sibling / parent has this disease. Am I at higher risk of developing glaucoma?

  The risk of developing primary open angle glaucoma increases nine times if your parent has this type of glaucoma. You must check your eyes periodically to rule out glaucoma as this disease can develop at any age , though commonly after 40 years of age.

  F

  One of my relatives had LASER for glaucoma after which their glaucoma got “cured”. Is there such a cure?

  As mentioned above, some variants of glaucoma can be curable if diagnosed at an early age. The most common of these is angle closure suspect, where the disease can be brought to a halt at times by simply making an additional path ( via LASER peripheral iridotomy) for the drainage of the aqueous fluid. Your doctor will explain this in detail if you have angle closure related problems. In other cases, with synechiae or plateau iris, even after LASER , medicines or surgery may be needed. Primary open angle glaucoma is not curable with LASER.

  G

  Will medicines or surgery cure my glaucoma?

  Eye Drops are available for control of eye pressures, which is essentially the treatment for most types of glaucoma. Medicines can only slow the progression of glaucoma to a level where it does not affect the vision in an adverse way throughout most of your active life. Primary open angle glaucoma cannot be cured as of 2022. Without medicines, irreversible blindness is guaranteed in a high-pressure glaucoma. Surgery in essence does the same thing as drops, it reduces the eye pressure to a stable level where glaucomatous optic nerve damage occurs at slowest possible rate. Making the eye pressure below a certain level ('<'6mmHg) causes other complications in the eye , therefore , there is a limit to how much eye pressure control can be done.