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Glaucoma

GLAUCOMA

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GLAUCOMA
Glaucoma is one of the major causes of blindness. Glaucoma is a group of conditions, in which high pressure inside the eye (intraocular pressure) damages the optic nerve...

 

Glaucoma is one of the major causes of blindness. Glaucoma is a group of conditions, in which high pressure inside the eye (intraocular pressure) damages the optic nerve of the eye. Glaucoma usually affects both the eyes. It commonly occurs in adults above 40 years of age, but can even occur in newborn babies. The vision lost due to glaucoma is irreversible and can not be regained. Hence it is very important to detect this disease as early as possible and treat early to preserve vision.

What is high eye pressure and how does it damage the vision?

The eye is filled with a fluid (aqueous), which is there at a certain pressure, called intraocular pressure (IOP). This fluid is continuously formed within the eye and is also simultaneously drained out, to maintain a stable pressure. The blockage of the normal outflow mechanism generally leads to an increase in the pressure, which damage the optic nerve of the eye. The optic nerve connects the eye to the brain and relays the visual signal. This damage to the optic nerve results in loss of peripheral visual fields initially and later on affects the central vision as well.

What are the types of glaucoma?

There are two main types of glaucoma- 1) Open angle glaucoma is the commoner form and it leads to slowly progressive loss of vision. 2) Closed angle glaucoma is also called acute glaucoma. The sudden blockage of fluid outflow from the eye leads to severe pain, nausea, vomiting and blurred vision. This is a medical emergency requiring immediate treatment or else blindness may occur in a day or so.

  • Loss of peripheral vision: this is often not noticed until considerable damage has occurred
  • Blurred or foggy vision : Frequent change of glasses for near work
  • Heaviness or dull pain in the eyes : Pain and redness of the eye
  • Halos or rainbow colored rings perceived around lights


What are the symptoms of glaucoma in children (congenital)?

The symptoms are redness, watering, photophobia (inability to tolerate light), enlargement of the eyes, and corneal clouding. Glaucoma in children needs to be managed very early and aggressively, in order to save their vision.

How is glaucoma diagnosed?

The aim of diagnosis in glaucoma is to diagnose the presence of the condition, to determine the extent of the damage and to monitor the progress of the damage due to the disease. There are various tests done to measure the pressure (tonometry), look for the optic nerve changes (fundus examination) and to document the visual field defects (perimetry). The diagnosis is confirmed on basis of the clinical condition and these findings. These special tests need to be repeated at regular intervals to document the progression of the disease.

Can glaucoma occur at normal eye pressure also?

Yes. Each eye has different capacity for tolerating the pressure. What may be normal for majority of eyes may be high for certain eyes. There is a subtype of glaucoma called 'Normal Tension Glaucoma' in which the eye pressure is apparently within the normal range, but still the optic nerve gets damaged. Hence, presence of 'normal' pressure alone does not rule out glaucoma. In suspected cases, one would like to do other tests as well, even if the pressure is 'normal'.

What is the treatment of glaucoma?

The aim of the treatment is to preserve the visual function by controlling the eye pressure (IOP) at the optimum level. The level of IOP required (target pressure) depends upon the extent of damage and other factors and is decided by the treating doctor. Medical treatment is generally the first line of management. It includes eye drops and tablets to control the pressure by either increasing the drainage or decreasing the production of the fluid in the eye. 

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