What is it?
Glaucoma, also called the ‘Silent Thief of Vision’, is a disease that affects the eye by causing damage to the optic nerve, leading to permanent and irreversible loss of vision. Patients will start to see a black frame in their vision that will increase in size slowly and steadily until it finally covers the vision completely.
Glaucoma patients can prevent the loss of vision if the condition is diagnosed early and treatment is done almost immediately.
The secretion of the Aqueous Humor, a fluid that flows across the front part of the eye before getting drained out, maintains the nourishment and pressure of the eye.
In glaucoma patients, the drainage path is blocked either partially or completely leading to a pressure buildup. This can damage the optic nerve leading to loss of vision gradually. The pressure in the eye can also go up due to the following reasons,
- Too much fluid production
- Eye diseases like cataract, Iritis, etc.
- Use of steroid-containing drops, tablets
Some of the risk factors for glaucoma are:
- Age typically over 40 years
- Near-sightedness or Myopia
- Family history of glaucoma
- Past eye injuries
- History of severe anemia or shock
Types of Glaucoma
- Congenital or developmental glaucoma : Congenital glaucoma is a group of diverse disorders in which abnormal high intraocular pressure results due to developmental abnormalities of the angle of the anterior chamber obstructing the drainage of aqueous humour. Sometimes, glaucoma may not occur for several years after birth; therefore, the term developmental glaucoma is preferred to describe such disorders.
- Primary open-angle glaucoma and related conditions : As the name implies, it is a type of primary glaucoma, where there is no obvious systemic or ocular cause of a rise in the intraocular pressure. Primary open-angle glaucoma, also known as chronic simple glaucoma of adult onset, is typically characterized by:
- Slowly progressive intraocular pressure
- Open normal appearing anterior chamber angle
- Characteristic optic disc cupping
- Specific visual field defects
- Primary or Acute angle-closure Glaucoma : Primary angle closure disease is the condition where the blockage is caused by narrow angles between the cornea and the iris. It is characterized by apposition of peripheral iris against the trabecular meshwork resulting in obstruction of aqueous outflow by the closure of an already narrow-angle of the anterior chamber. The condition is not associated with any other ocular and systemic abnormalities. The sudden increase in intraocular pressure causes,
- Intermittent blurring
- Severe eye pain & redness
- Headache & brow ache
- Rainbows like haloes around lights
- Nausea and vomiting
Diagnosis : Some of the common diagnostic tests for glaucoma are
- Tonometry: measures the pressure of the inner eye
- Ophthalmoscopy: examines your optic nerve for glaucoma damage
- Perimetry: is a visual field test that produces a map of the patient’s complete field of vision
- Gonioscopy: helps to determine whether the angle where the iris meets the cornea is open and wide or narrow and closed
- Pachymetry: is a simple, painless test to measure the thickness of the cornea, which is the clear window at the front of the eye
- Eye Drops: is used as the first line of defense for treating glaucoma and has to be used for the entire life of the patient. The dosage depends on the severity of the disease, it could be used either once or several times a day and sometimes in combinations.
- Laser Surgery: involves usually the laser in creating a hole in the iris to improve the flow of aqueous, providing adequate and
- Surgery: is recommended by the doctor to control non-responsive glaucoma clinically. It is also done along with Phaco IOL surgery where a new drainage channel is created through which the aqueous fluid can leave the eye, lowering the IOP and effectively controlling glaucoma in most of the patients.
Why Amrit? : Amrit Hospital is equipped with the latest technology that can help identify and diagnose glaucoma at an early stage to prevent loss of vision. Some of the latest equipment present in Amrit Hospital are:
- Topcon Not Contact Tonometry (Japan): is used to measure the pressure inside the eye
- Hagg Streit Applanation Tonometry (Swiss): is the Gold standard in measuring the eye pressure.
- Gonioscopy 2 mirror: is essential when used to view the angle of the anterior chamber and to visualize the abnormalities in the drainage path.
- Alcon Pachymetry (USA): is used to measure the thickness of the cornea and is also a guide to calculate the appropriate target intraocular pressure
- Zeiss Visual Field Examination: is the gold standard for analyzing the visual fields to see the extent of the loss of side vision. The yearly repetition of the visual fields is used to assess the efficacy of the control of the eyedrops.