Glaucoma Treatment
Glaucoma is called the “Silent Thief of Sight” Don’t Let Glaucoma Steal Your Sight!
Glaucoma Clinic Services
The Services Offered include:
- Accurate tonometry instrumentation like Goldman Applanation Tonometer, Perkins tonometer, i. care No Anaesthesia Tonometer and Non Contact Tonometer – To measure the intraocular pressure.
- Humphery Perimeter for visual field examination.
- Topcon fundus Photography for optic disc documentation by color and Red free photographs.
- Optic disc imaging and Retinal nerve fiber layer analysis by optical coherence tomography (OCT).
- Nd- Yag Laser facility for Yag Laser Iridotomy.
- Glaucoma Surgeries like Trabeculectomy and combined procedure of Cataract Surgery and Trabeculectomy.
- Cyclodestructive procedures like Cyclocryopexy and Trans scleral cyclo photocoagulation.
- Glaucoma Drainage Device like AGV implantation.
Available Instruments in the Department:
- Apart from the equipments available for routine evaluation of glaucoma (Applanation tonometer, 3 and 4 mirror gonioscope, 90 D stereoscopic evaluation of the disc), other specialized equipments include
- Tonopen.
- Perkins handheld Applanation tonometer.
- Koeppe direct gonioscopes (for pediatric angle assessment).
- Humphery visual field analyzer.
- Optical coherence tomography (OCT).
- Anterior Segment OCT.
- Ultrasound Biomicroscopy (UBM).
- Fundus photography unit (for stereoscopic disc photography).
Outpatient Activities:
- Routine screening for glaucoma patients (Applanation tonometry, gonioscopic angle evaluation, optic disc evaluation with 90 D).
- Visual Field Analysis.
- Gonioscopic and Disc photography – wherever necessary.
- Management of common and rare glaucoma entities including pediatric glaucomas.
- Cross consultations from other departments include complicated and post glaucoma (such as post penetrating Keratoplasty, post vitreo – retinal surgeries, Post traumatic) and their management.
Minor OPD Procedures:
- Nd: YAG peripheral Iridotomy.
- Argon Laser Suturelysis.
- Postoperative 5 – Fluorouracil injections.
Minor:
- Evaluation under anesthesia for pediatric glaucomas.
- Diode cyclophoto coagulation and Cyclo cryo therapy.
Educational and Research Activities:
- Conducting CMEs.
- Antiglaucoma drug trials.
- Fully equipped Glaucoma Clinic offers wide range of Diagnostic and Therapeutic modalities for Glaucoma.
What is Glaucoma?
Glaucoma is one of the leading causes of irreversible blindness in the world, especially for older people. However visual loss is preventable or stabilized with early diagnosis and treatment. Glaucoma is a condition of the eye where the optic nerve is damaged. The optic nerve carries images to the brain, which are then perceived as vision. Minute nerve fibers from various parts of the retina join to form the optic nerve. Glaucoma results when the pressure within the eye is high enough to be detrimental to the normal functioning of these nerve fibers, some of which stop functioning. Non-functional nerve fibres result in a loss of retinal function in the area from where they originate, leading to defects in the field of vision.
The disease is called the `sneak thief of sight´ because it is painless, symptomless and irreversible. Therefore, the person with glaucoma is usually unaware of it until much loss of vision has occurred. In fact, half of those suffering damage from glaucoma do not know it. Currently, damage from glaucoma cannot be reversed and if the entire nerve is damaged, blindness results. Early detection and regular treatment are the keys to preventing optic nerve damage and blindness from glaucoma.
Causes of Glaucoma
The aqueous humour is the clear fluid circulating within and nourishing some parts of the eye which have no blood supply. ‘Normal’ individuals have an equal production and drainage of this fluid resulting in a constant pressure within the eye. If the drainage is compromised due to any reason, there is a pressure build-up in the eye, which can damage the optic nerve.
The different types of glaucoma are
Chronic open-angle glaucoma
It is the most common type of glaucoma; damages vision gradually and painlessly. The pressure is rarely high enough to be symptomatic.
Angle-closure glaucoma
An acute attack of glaucoma caused by sudden blockage of the drainage channels leads to a sharp rise in pressure within the eye causing blurred vision, severe eye pain, nausea and vomiting, headache, rainbow haloes around lights, pain around your eyes after watching TV or after leaving a dark theater and red eyes.
An acute attack requires the immediate attention of an eye doctor.
Detection
Regular eye examinations by the ophthalmologist leads to detection.
The complete and painless examination includes among other tests:
- Tonometry – Measurement of the intraocular pressure [tension]
- Gonioscopy – Inspection of the drainage angle of the eye
- Ophthalmoscopy – Evaluation of optic nerve damage
- Perimetry – Testing the visual field of each eye
Treatment
The main treatment for chronic glaucoma aims at reducing the pressure in your eye. Damage already caused by glaucoma cannot be reversed. Eye drops, tablets, laser and surgical operations are used to prevent or slow further damage from occurring. With any type of glaucoma periodic examinations are very important to prevent loss of vision. Because glaucoma can irreversibly worsen without your being aware of it, your treatment may need to be changed from time to time during the periodic examination.
MEDICAL TREATMENT:
Eye drops
When taken regularly and continuously as prescribed, they control the eye pressure either by slowing the formation of aqueous fluid within the eye or by increasing the flow at the drainage area.
Tablets
These are sometimes combined with the eye drops to decrease higher levels of eye pressure. They are occasionally known to cause tingling of fingers and toes, bowel irregularities, and in the very long term, kidney stones.
Why a drug causes side effects in some persons and not others is not fully understood.
Laser surgery
Lasers of different types are usually used in one of three ways:
In open-angle glaucoma the draining area itself is enlarged to control eye pressure.
In angle-closure glaucoma the laser creates a hole in the iris to open up and improve the flow of aqueous fluid to the drain.
In painful late-stage glaucoma medication or surgery do not control the pressure. The laser closes some aqueous fluid-producing areas in the eye and lowers the eye pressure.
Operative surgery
A new drainage channel is created for the aqueous fluid to leave the eye. Sometimes a tube drains the fluid in very resistant cases.
Our Glaucoma Service Experts
Meet our team of world-class experts, who are committed to improving the quality of life and vision of their patients, and to researching and developing new diagnosis and treatment methods for the disease.
Dr. R. KrishnaPrasad
Paediatric Ophthalmology and Glaucoma
Dr. Vijayalaxmi Kori
Glaucoma & Anterior Segment Specialist