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Glaucoma & Neuro-Ophthalmology

About Glaucoma & Neuro-Ophthalmology

Glaucoma

Glaucoma is a leading cause of permanent blindness in individuals aged 40-years and above. It affects both the genders; however, the preponderance of type of glaucoma may vary. Of several types of glaucoma, two more prevalent types diagnosed among Indians are open angle glaucoma and angle closure glaucoma. The prevalence of both types of glaucoma increases with age.

RISK FACTORS

There are certain risk factors for glaucoma, which include but not limited to, increasing age, increased intra-ocular pressure (IOP), high refractive errors (both myopia and hyperopia), trauma, intake of steroid group of drugs in any form, and family history. If you or your family member have any of these, its prudent to consult your eye specialist and get your eyes checked up. None but raised IOP is a modifiable risk factor. Measurement of IOP is an integral part of your examination, if you have glaucoma. 

EFFECT ON VISUAL FIELD

Since glaucoma involves loss of visual field, the prudent approach is to monitor one’s visual field. The glaucoma patient must regularly undergo the visual field test in consultation with his/her treating ophthalmologist. The number of vision fields to be performed may vary from patient to patient. It is advisable to have at least two visual fields in a calendar year. There are certain other imaging tools like OCT or HRT, which may be done in course of your treatment to detect any deterioration of your diseased eye. 

To preserve your visual fields, your consultant eye specialist treats you by reducing your IOP. The IOP can be reduced by various means including topical eye drops, laser or surgical interventions. In majority of cases diagnosed with glaucoma topical eye drops or laser is first line of treatment. It’s a common myth that eyes affected with glaucoma, cannot be operated. But it’s equally true that surgery is done to prevent further loss of vision rather than to restore lost vision. Hence, essentially the vision loss in glaucoma is irreversible. And that is the reason that one should be very vigil about his/her treatment.

Your visual field may continue to deteriorate despite reduction in IOP. In such situations your doctor may order some tests or investigations. He/she may order a 12 to 24 hour monitoring of your IOP. Your doctor may step up the treatment by substituting or adding eye drops to your treatment regimen. You may need laser or surgery to control your IOP if the drugs fail to control this or you become intolerant to one or more drugs. 

In brief glaucoma is a chronic condition which requires a good care and compliance to preserve your vision. 

MANAGEMENT

Frequently Asked Questions

Answer: Glaucoma is a disease of eye in which optic nerve (the nerve which carries vision from eyes to brain) is permanently damaged.

Answer: Glaucoma causes permanent blindness, which can’t be restored with treatment. However, with treatment further damage can be prevented.

Answer: Most common cause of glaucoma is increase in pressure inside the eye. This pressure may increase from different mechanisms, based upon there are different types of glaucoma. However, glaucoma may occur in presence of normal pressure also

Answer: Everyone. The risk of glaucoma increases with increase in age. The risk rises after age of 40 years. Some type of glaucoma may be present at birth or may start in early childhood or young age. Other risk factors are use of some drugs like steroids, high power of glasses in short sightedness or long sightedness, family history of glaucoma, injury to eye or previous retinal surgeries etc.

Answer: Yes, glaucoma is treatable. The disease cannot be cured but blindness from disease can be prevented.

Answer: During glaucoma management, your doctor monitor glaucoma using certain clinical parameters like pressure in eye or damage to optic nerve.  Your ophthalmologist would subject you regularly to visual field tests or OCT etc. Generally, these tests are repeated every 4-6 months, though actual frequency may vary with individual cases. 

Answer: The management of glaucoma depends upon its type. Generally, glaucoma management involves reduction in pressure in eyes using either of eye drops or LASER or surgical intervention.

Answer: We cannot prevent onset of glaucoma. The management is directed towards preventing vision loss to avoid blindness I life time of the patient. The best way to achieve this is regular eye check-ups with your eye doctor. The recommended frequency is once in 2 years below age of 40 years, once in a year between 40-60 years, and every 6 month after 60 years of age.

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