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Glaucoma

Glaucoma

Glaucoma is one of the leading causes of irreversible blindness in the world. However visual loss is preventable or stabilized with early diagnosis and treatment. Glaucoma is a complicated disease in which damage to the optic nerve leads to progressive, irreversible vision loss. The optic nerve is connected to the retina — a layer of light-sensitive tissue lining the inside of the eye — and is made up of many nerve fibers, like an electric cable is made up of many wires. The optic nerve sends signals from your retina to your brain, where these signals are interpreted as the images you see.

In the healthy eye, a clear fluid called aqueous (pronounced AY-kwee-us) humor circulates inside the front portion of your eye. To maintain a constant healthy eye pressure, your eye continually produces a small amount of aqueous humor while an equal amount of this fluid flows out of your eye. If you have glaucoma, the aqueous humor does not flow out of the eye properly. Fluid pressure in the eye builds up and, over time, causes damage to the optic nerve fibers.

His disease is painless, symptomless and irreversible. Therefore, the person with glaucoma is usually unaware of it until much loss of vision has occurred. Early detection and regular treatment are the keys to preventing optic nerve damage and blindness from glaucoma.

The different types of glaucoma are

  • Chronic open-angle glaucoma
  • It is the most common type of glaucoma; damages vision gradually and painlessly. The pressure is rarely high enough to be symptomatic.

  • Angle-closure glaucoma
  • An acute attack of glaucoma caused by sudden blockage of the drainage channels leads to a sharp rise in pressure within the eye causing blurred vision, severe eye pain, nausea and vomiting, headache, rainbow haloes around lights, pain around your eyes after watching TV or after leaving a dark theatre and red eyes.

    An acute attack requires the immediate attention of an eye doctor.

Detection

Regular eye examinations by the ophthalmologist leads to detection.

  • Tonometry – Measurement of the intraocular pressure [tension]
  • Gonioscopy – Inspection of the drainage angle of the eye
  • Ophthalmoscopy – Evaluation of optic nerve damage
  • Perimetry – Testing the visual field of each eye
  • OCT – a newer modality of diagnosing glaucoma but fast gaining ground

‘Suspect’ cases with a family history of glaucoma may be required to additionally undergo a highly sensitive form of visual field analysis called short wavelength automated perimetry [SWAP], which detects changes well before the optic nerve shows the effects of glaucoma. It is also useful to monitor the early progress of the condition.

Who is at risk for glaucoma?

Everyone should be concerned about glaucoma and its effects. It is important for each of us, from infants to senior citizens, to have our eyes checked regularly, because early detection and treatment of glaucoma are the only ways to prevent vision impairment and blindness. There are a few conditions related to this disease that tend to put some people at greater risk. This may apply to you if:

People with more risk of developing glaucoma include people who:

  • are over age 40
  • have family members with glaucoma
  • have high eye pressure
  • are farsighted or nearsighted
  • have had an eye injury
  • have corneas that are thin in the center or
  • have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body.
  • Long term usage of steroids

Treatment

The main treatment for chronic glaucoma aims at reducing the pressure in your eye. Damage already caused by glaucoma cannot be reversed. Eye drops, tablets, laser and surgical operations are used to prevent or slow further damage from occurring. With any type of glaucoma periodic examinations are very important to prevent loss of vision. Because glaucoma can irreversibly worsen without your being aware of it, your treatment may need to be changed from time to time during the periodic examination.

Medical treatment

  • Eye drops
  • Medicated eye drops are the most common way to treat glaucoma. These medications lower your eye pressure in one of two ways — either by reducing the amount of fluid created in the eye or by helping this fluid flow out of the eye through the drainage angle.
  • These eyedrops must be taken every day. Just like any other medication, it is important to take your eyedrops regularly as prescribed by your ophthalmologist.

    Once you are taking medications for glaucoma, your ophthalmologist will want to see you regularly. You can expect to visit your ophthalmologist about every 3–6 months. However, this can vary depending on your treatment needs.

Surgery

Surgery is advised only when the medications are not able to bring down the pressures. There are a few types of surgery that the doctor can advise depending on the severity of the condtion.

1) Trabeculectomy

2) Valve implantation

Appointments

Date

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