Glaucoma

Glaucoma is the world’s leading cause of preventable blindness and is a group of eye diseases that damage the optic nerve.

Worldwide, about 70 million people have glaucoma and approximately half do not know that they have it. In the early stages, often no symptoms are seen.

Risk Factors For Glaucoma :

  • Raised intraocular pressure
  • Age more than 40 years
  • Positive family history
  • High blood pressure
  • Long term steroids
  • Marked nearsightedness
  • Race people of African and Asian descent are at increased risk


COMMON TYPES OF GLAUCOMA :

1. OPEN ANGLE GLAUCOMA –
It is the most common type of glaucoma and is associated with raised IOP due to inability for aqueous fluid to flow correctly. Low or Normal tension glaucoma is characterised by progressive optic nerve damage and visual field loss with a statistically normal intraocular pressure.

2. ANGLE CLOSURE GLAUCOMA –
It is a form of glaucoma where the anterior chamber tends to be smaller than average and fluid is prevented from exiting the eye by a blockage of the drain.

DIAGNOSING GLAUCOMA –
Routine eye exams are crucial to detect glaucoma before serious, irreversible vision loss occurs. As a part of comprehensive eye exam, eye specialist can perform a variety of tests to determine if someone has glaucoma.

  • Ophthalmoscopic examination of the retina and Optic Nerve.
  • Applanation Tonometry
  • Gonioscopy – To view the drainage angle and trabecular meshwork
  • Automated Perimetry – Visual field analysis
  • Nerve Fibre Analyser – Optic Nerve analysis

PROGNOSIS :
Treatment can slow the disease progression. Lowering eye pressure and keeping it under control reduces the potential for glaucoma to progress. But it has been seen that some of the eyes are genetically programmed for glaucoma and the phenomenon of apoptosis goes on inspite of treatment.

TREATMENT:
Prescription of eye drops is the most common type of treatment.
Laser in glaucoma is used for doing Trabeculoplasty, Iridectomy etc.


SURGERY:
Filtration Surgery ( Trabeculotomy) : This is the most common type of surgery done and accepted worldwide for glaucoma. An internal window is created which acts as filtration site and drains fluid into the subscleral space.

Drainage Implants:
There are various implants/valves available to handle refractory cases of Glaucoma. They can be valvular or non-valvular.

Other Surgeries –
Viscocanalostomy