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Patient education

Information
About
Glaucoma

Pallab K Shome
Pallab K Shome

What is glaucoma?

Glaucoma is a group of diseases where the optic nerve (nerve which helps us to see) is gradually damaged, when the pressure inside the eye is higher than what the optic nerve can withstand.

What happens in glaucoma?

When the optic nerve becomes weak, the person gradually loses vision. In early glaucoma,peripheral vision of the person is gradually lost.To perform our day to day activities, our central vision is necessary so the gradual progressive loss of peripheral vision goes unnoticed by the patient. By the time one realizes about the visual disability, the glaucoma has become advanced hence this disease is often said to be “the sneak thief of sight.”

Pallab K Shome
Pallab K Shome

What causes glaucoma?

Usually in glaucoma the intraocular pressures rises or fluctuates and this causes damage to the Optic nerve.The Intraocular pressure is maintained because of a fluid called aqueous humor circulating in the eye. If there is an imbalance between the production and drainage of aqueous humors, it causes the Intraocular pressure to rise or fluctuate.

What are the symptoms of glaucoma?

  • Usually ASYMPTOMATIC
  • Blurred vision
  • Seeing coloured haloes
  • Partial /peripheral loss of vision
  • Frequent change of presbyopic glasses
  • Redness, pain and heaviness in the eyes
Pallab K Shome
Pallab K Shome

What are the tests used to diagnose glaucoma?

Diagnosis of glaucoma needs a comprehensive eye examination

The common tests used are :

 

  • Tonometry (Intraocular measurement)
  • Gonioscopy (Looks into the drainage pathway of the eye)
  • Dilated Fundus examination (Looks into the Optic Nerve Head)
  • Perimetry (Visual field testing)
  • OCT (Ocular Coherence Tomography)

How is glaucoma treated?

Once glaucoma has been diagnosed, treatment should begin at the earliest to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage from occurring. Most cases of glaucoma can be treated with eye drops, laser surgery or microsurgery. The best treatment for your individual case depends on the type and severity of the disease, and can be discussed with your doctor.

 

  • Eye drops are used to reduce fluid production in the front of the eye or to help drain excess fluid.
  • Laser surgery for glaucoma aims to increase the outflow of fluid from the eye or eliminate fluid blockages through laser trabeculoplasty, iridotomy or cyclophotocoagulation.
  • Microsurgery involves a surgical procedure called a trabeculectomy, which creates a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma.
Pallab K Shome
Pallab K Shome

How long should I use medicines?

Glaucoma needs lifelong treatment. The medications can change depending on the severity of the disease and the control of Intraocular pressure. The changes in Intraocular pressure and the progression of the disease can be assessed by regular followup. Regular follow up and putting the eyedrops on time are the key to control glaucoma.

How can I prevent glaucoma?

While there are no foolproof ways to prevent glaucoma from developing, regular screenings and early detection are the best forms of protection against the harmful damage that the disease can cause. While anyone can develop glaucoma, some people are at a higher risk for developing disease. These people may include those who:

 

  • Are over the age of 40
  • Have a family history of glaucoma
  • Have poor vision
  • Have diabetes
Pallab K Shome
Pallab K Shome

How can you help successfully manage glaucoma ?

  • Take your medicines regularly as prescribed.
  • Do not stop medications without consulting your doctor.
  • Regular followup visits as suggested by your doctor. These visits will ensure that your disease is not worsening.
  • Do not miss appointments for the tests of glaucoma (perimetry) which will help your doctor judge your disease progression.
  • Know your risk factors and get yourself examined at the earliest.
  • A diagnosis of glaucoma does not necessarily mean blindness. Early diagnosis and appropriate treatment can halt the progress of glaucoma.

Myths And Facts

 

Dr Sailaja Sengupta (Nair)
Myth 1 : I can see clearly, so I cannot have glaucoma!
Fact : Glaucoma in early to moderate stages doesn’t affect your vision. It is only when the disease becomes advanced is the vision affected. Hence it is oKen called “silent thief of sight”. So earlier the diagnosis beOer are the chances of preserving vision.
Fact : Glaucoma can affect anyone. Most glaucoma cases are found in people over 40, which means you can develop the disease long before you hit senior ciTzen status. While the majority of glaucoma cases are age-related, mulTple types of glaucoma can affect newborns and people in their 20s.
Fact : Glaucoma tends to run in families. Several studies have idenTfied some genes that are potenTally related to high eye pressure and opTc nerve damage. So people with a family history of glaucoma have a relaTvely higher risk of developing glaucoma. There are many people who are the only ones having glaucoma. Absence of glaucoma in family does not mean you are safe. So it is very important to have your eyes examined by an ophthalmologist at least once at 40 years of age as this is the Tme around which the early signs of the disease begins to occur.
Fact : Although elevated eye pressure is the major cause of glaucoma, some paTents with glaucoma do not have high eye pressure. These people have normal tension glaucoma and they have sensiTve opTc nerve and impaired blood supply to the opTc nerve e.g in artherosclerosis where there is faOy deposits in the blood vessels.
Fact : The change in eye pressure cannot be appreciated in most cases without measuring it by a tonometer. In some people,there can be an acute rise of eye pressure which may cause pain. However in majority of glaucoma paTents there are no symptoms. So glaucoma is also called “Silent thief of sight”.
Fact : Glaucoma is a disease of the opTc nerve which results in visual field damage and thereby affects vision. It is very important to measure the opTc nerve and visual field changes in addiTon to eye pressure to know the status of your glaucoma. So tests like dilaTon of the eye to assess the opTc nerve and reTna, OCT(Ocular Coherence Tomogragraphy) are important invesTgaTons done to assess your glaucoma.
Fact : Visual field tesTng and OCT are important tests done to know the status of your glaucoma. Your doctor will tell you how oKen you need to do it. This depends on the stage of your glaucoma and how well it is controlled
Fact : Glaucoma if leK untreated can lead to blindness. So it is very important to visit your doctor so that the disease is diagnosed early to preserve your vision.
Fact : The surgery done for glaucoma is to control your eye pressure which were not being controlled with medicaTons. It has been seen that lowering Intraocular pressure is an important way of prevenTng the progress of the disease. But Glaucoma is lifelong disease which will need monitoring to see if the disease is progressing.
Fact : Glaucoma is chronic disease like diabetes and hypertension, it needs treatment with eyedrops to control your eye pressure which is the only modifiable risk factor. Our eye pressure changes through out the day so your doctors has advised you the drops to miimise the fluctuaTons.So it is very important not to miss a dose and to put your drops on Tme.

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