“Sight is one of our most valued senses that connects our brain to the outside world.”
Glaucoma is an umbrella term that includes various eye ailments that affect the optic nerve, often leading to vision loss. Being more prevalent in the 50+ age group people, it may occur earlier too, mostly due to inherited genes.
Glaucoma is the leading cause of permanent blindness worldwide. Therefore, it is advisable to consult an expert doctor for any sign of discomfort. The vision loss due to Glaucoma is irreversible, but it can be conveniently avoided or controlled if administered at an early stage.
What is Glaucoma?
Glaucoma is a chronic, progressive eye disease caused by an abnormally high intraocular pressure (IOP) that results in damage to the optic nerve (the nerve which carries visual signals from the retina to the brain and allows us to see), leading to vision loss.
This happens because of a fluid build-up in the front part of the eye, exerting pressure on the eye and causing the nerve to deteriorate over time.
What causes the damage to the optic nerve?
Constant raised eye pressure is a major risk factor that may be caused due to abnormality in the eye’s drainage system leading to fluid build-up and pressure. Thus, resulting in damage to the optic nerve.
Raised eye pressure is also known as ocular hypertension in medical terms. It is an imbalance in the production and drainage of aqueous humor (the fluid inside the eyes). When obstruction occurs in the drainage channel pressure is developed.
Types of Glaucoma
It occurs when a congenital defect in the angle of the anterior chamber obstructs the outflow of aqueous humor. It can be classified into three types, true, infantile, and juvenile.
(1) Primary: There are two types –
Open-angle Glaucoma: The angle (structure of the drainage pathway in the front of the eye) appears open, but several factors including drainage problems result in poor vision. This type can also occur at both normal and high eye pressure.
Angle-closure Glaucoma: The angle is narrow and the resulting structural problem can lead to the abrupt closure of the drainage pathway, leading to a sudden increase in eye pressure. This is known as acute angle closure. It needs immediate treatment.
(2) Secondary: Glaucoma can develop as a complication from other conditions too like eye injuries, diabetes, and prolonged use of steroids.
(3) Low Tension Glaucoma: It’s a rare kind. Here the eye pressure is normal but the optic nerve still gets damaged. The causes are not known yet.
Symptoms of Glaucoma
Glaucoma can sneak up on you without obvious signs and symptoms, therefore it is crucial to identify the following risk factors, and consult an eye specialist to understand the situation. Book an appointment with best eye clinic if you see any of the following signs and symptoms:
• Eye pain or pressure
• Rainbow-colored halos around lights
• Low vision, blurred vision, narrowed vision (tunnel vision), or blind spots
• Nausea and vomiting due to increased pressure
• Redness in eyes
Eye doctors would consult and evaluate your vision, based on the following two steps.
• Regular eye examination by an ophthalmologist
• A medical history, and family history to determine the risk
Who is at the risk?
Underlaying causes are still unrevealed and studies are going on throughout the world. Still, certain factors have been ruled out.
• Age old than 50
• A first-degree relative with Glaucoma i.e., studies suggest it to be hereditary
• History of eye trauma or multiple surgeries
• Highly near-sighted or far-sighted
• Patients with diabetes
• People on medication of steroids
• Slit lamp – A slit lamp is a microscope with a bright light used to examine the eyes of patients. This special microscope shows the 3D view of the eyes and indicates any signs of increased eye pressure.
• Gonioscopy – This test measures the risk of Glaucoma by evaluating the patient’s eye’s drainage angle, also known as the anterior chamber angle. A blocked or closed drainage angle denotes the chances of Glaucoma.
• Tonometry – This test measures the eye pressure and any changes that occurred. The test evaluates the risk of developing Glaucoma, detects if Glaucoma is present, and also checks the performance of Glaucoma treatment when being taken.
• Ophthalmoscopy – Through this diagnostic procedure, the doctor examines the optic nerve for glaucoma damage.
• Fundus Photography – This is generally considered very useful for diagnosing glaucoma in eyes showing a classic glaucomatous appearance, but only expert doctors can perform this.
While nerve damage and visual loss from glaucoma cannot be reversed or cured, they can be controlled. The treatments prevent further damage and keep the eye pressure under control to prevent vision loss. Expert Ophthalmologists diagnose and treat it medically or surgically.
Treatment can be done involving eyedrop medications, pills (rarely), laser, or incisional surgery.
1. Treating Glaucoma with Medicines
After diagnosis, the Ophthalmologist often prescribes an eyedrop containing more than one class of drug to patients for the control of their glaucoma. The eye drops need to be instilled in the affected eye, to reduce the eye pressure.
Medical management can be done using the following:
• Beta-Adrenergic blockers: help in decreasing aqueous humor production.
• Cholinergic (Miotics): helps to reduce IOP.
• Carbonic Anhydrase inhibitors: these are used to decrease the formation and secretion of aqueous humor.
• Prostaglandins Analogs: these analogs are used to reduce IOP by increasing uveoscleral outflow.
2. Treating Glaucoma with Laser Surgery
If medication is not sufficient, some patients are suggested surgery. There are several forms of laser therapies for glaucoma. It is an effective mode of treatment with fewer possibilities of complications. The three most common laser procedures are:
3. Treating Glaucoma with Glaucoma Surgery
When a microsurgical procedure is required to treat glaucoma, a small surgery is conducted. During this operation, the clogged part is removed, and a new drainage pathway is created for the fluid to exit the eye.
Surgical Management is generally done following the below-mentioned procedures:
• Cyclo Cryotherapy
• Filtering Procedures
• MIGS (Minimally Invasion Glaucoma Surgery)- This method is the newest of all and is generally preferred for mild to moderate Glaucoma. Here implantable microscopic stents and shunts are used to increase fluid drainage.
Till day Glaucoma is not curable but awareness and early diagnosis can help in slowing down the progress of this condition. In addition, proper guidance and treatment from an experienced ophthalmologist are a must. With the advancement in the medical field, treatment for Glaucoma focuses on more targeted and personalized treatment. If you are looking for best eye clinic in Pune, contact Aakash Eye Clinic and Laser Center.