Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in the patient’s eye. If the damage worsens, glaucoma can cause permanent vision loss or even total blindness within a few years. Most people with glaucoma have no early symptoms or pain. Glaucoma is one of the leading causes of blindness for people over the age of 60. Because vision loss due to glaucoma cannot be recovered, it is important to have regular eye exams that include measurements of eye pressure so a diagnosis can be made in its early stages and treated appropriately. If glaucoma is recognized early, vision loss can be slowed or prevented. A Glaucoma patient will generally need treatment for the rest of his/her life. Glaucoma, otherwise known as Kala Motia is an eye disease in which there is an increase in pressure inside the eye. Just as some people have high blood pressure, in the same way; a glaucoma patient has high eye pressure. If the eye pressure remains high for a long time it damages the optic nerve which carries the light sense from the eye to the brain.
This damage to the nerve is irreversible and leads to permanent and incurable blindness. That is why glaucoma is a dangerous disease of the eye and has been labeled as "lurking thief of vision". Glaucoma, known as a sneak thief of eyesight, is one of the most sight threatening conditions of the eye. It usually occurs among people above 40 years of age, especially those who have a family history of glaucoma. It is caused due to an excess build-up of fluid inside the eye, which, in normal cases, is drained into the blood stream itself. The fluid exerts pressure on vital parts of the eye, like the optic nerve, and causes irreversible damage.
SIGNS AND SYMPTOMS
Seeing of coloured halos around the source of light. Headache and pain in the eye. Gradual loss of peripheral vision vision and restriction of field of vision. Frequent change of spectacles.
PREVENTION
Glaucoma cannot be prevented, but blindness due to glaucoma can be avoided if detected early and treated properly and regularly.
TREATMENT
Regular check-up and medication as advised by the Eye-Doctor is a must for lifetime. In certain cases, the Ophthalmologist may advise surgery also. However, even after surgery, medications, as advised by the Doctor from time to time, must be strictly followed to avoid blindness. Early detection and regular treatment can prevent blindness due to Glaucoma.
Glaucoma Services available at Sri Sankaradeva Nethralaya
1. TRABECULECTOMY - Trabeculectomy is a type of glaucoma surgery performed on the eye that creates a new pathway for fluid inside the eye to be drained. This is an outpatient procedure performed in the operating room. It is used to prevent worsening of vision loss due to glaucoma by lowering eye pressure.
2. PHACO-TRABECULECTOMY – This is a combined surgical procedure wherein surgery for both, Cataract (Phacoemulsification or Phaco) as well as surgery for Glaucoma (Trabeculectomy) is performed. The indications for a combined procedure include a visually significant cataract, poorly controlled IOP (Intra Ocular Pressure) on multiple medications, IOP that is controlled on poorly tolerated medications, advanced glaucomatous damage and either controlled or uncontrolled IOP, and a desire to minimize operative and anesthetic risk by performing one procedure instead of two.
3. TRABECULECTOMY + TRABECULOTOMY - Trabeculotomy is a surgical procedure much like Trabeculectomy. The obstruction to the normal fluid pathway is removed by means of surgery so that normal fluid outflow of the eye is re-established. Trabeculotomy is a surgery for children only. Combined trabeculotomy with trabeculectomy is reported as a useful procedure in glaucoma resulting from Sturge-Weber syndrome.
4. GONIOTOMY - Goniotomy is a surgical procedure in which the doctor uses a lens called a Goniolens to see the structures of the front part of the eye (anterior chamber). An opening is made in the trabecular meshwork, the group of tiny canals located in the drainage angle, where fluid leaves the eye. The new opening provides a way for fluid to flow out of the eye. Goniotomy is a surgery for children only. Goniotomy is successful for more than 80 out of 100 children whose glaucoma was not present at birth. If pressure in the eye increases, the procedure may need to be repeated.
5. GLAUCOMA VALVE IMPLANTATION SURGERY - Implantation of Glaucoma Valve is an effective surgical technique to reduce intraocular pressure in patients affected with glaucoma. While in the past, the use of this device was reserved to glaucoma refractory to multiple filtration surgical procedures, up-to-date mounting experience has encouraged its use as a primary surgery for selected cases.
6. LASER IRIDOTOMY - Laser Peripheral Iridotomy (also described as 'laser iridotomy') is a medical procedure which uses a laser device to create a hole in the iris, thereby allowing aqueous humor to traverse directly from the posterior to the anterior chamber and, consequently, relieve a pupillary block.
7. LASER TRABECULOPLASTY - Laser Trabeculoplasty uses a much focused beam of light to treat the drainage angle of the eye. This surgery makes it easier for fluid to flow out of the front part of the eye, decreasing pressure in the eye. There are two types of laser trabeculoplasty:
Argon laser trabeculoplasty (ALT)
Selective laser trabeculoplasty (SLT)
8. LASER IRIDOPLASTY - Laser Iridoplasty is a safe and effective technique for relieving appositional angle closure. It contributes to the success of other procedures such as Iridotomy and Trabeculoplasty and provides definitive treatment for select conditions.
9. DIODE LASER CYCLOPHOTOCOAGULATION – Diode Laser CycloPhotocoagulation or DLCP, is a laser procedure by which the ciliary body, which creates fluid, is treated. It is reserved for refractory glaucoma where eye pressure cannot be lowered by either medication or surgery.
IMAGES OF GLAUCOMA
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