Glaucoma Glaucoma

Glaucoma is a leading cause of blindness
There is no cure (yet) for glaucoma
Everyone is at risk for glaucoma
There may be no symptoms to warn you

Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.

Estimates put the total number of suspected cases of glaucoma at around 65 million worldwide.

It is a group of eye diseases that gradually steal sight without warning. In the early stages of the disease, there may be no symptoms. Experts estimate that half of the people affected by glaucoma may not know they have it.

Vision loss is caused by damage to the optic nerve. This nerve acts like an electric cable with over a million wires. It is responsible for carrying images from the eye to the brain.

There is no cure for glaucoma-yet. However, medication or surgery can slow or prevent further vision loss. The appropriate treatment depends upon the type of glaucoma among other factors. Early detection is vital to stopping the progress of the disease.

It was once thought that high pressure within the eye, also known as intraocular pressure or IOP, is the main cause of this optic nerve damage. Although IOP is clearly a risk factor, we now know that other factors must also be involved because even people with "normal" levels of pressure can experience vision loss from glaucoma.


Adult glaucoma falls into two categories- open angle glaucoma and closed angle glaucoma . These are marked by an increase of intraocular pressure (IOP), or pressure inside the eye. When optic nerve damage has occurred despite a normal IOP, this is called normal tension glaucoma. Secondary glaucoma refers to any case in which another disease causes or contributes to increased eye pressure, resulting in optic nerve

Symptoms of angle closure glaucoma may include headaches, eye pain, nausea, rainbows around lights at night, and very blurred vision.

Everyone is at risk for glaucoma. However, certain groups are at higher risk than others. People at high risk for glaucoma should get a complete eye exam, including eye dilation, every one or two years

The following are groups at higher risk for developing glaucoma

People Over 60
Family Members with Glaucoma
Steroid Users
Eye Injury
Other Risk Factors
High Myopia (nearsightedness)
Central corneal thickness less than .5 mm

SRN specialists continuously fight the severe consequences of not detecting the disease in its early stages To achieve an accurate assessment, experienced ophthalmologists perform a comprehensive glaucoma screening that consists of three non-invasive, pain-free procedures:

Measurement of intraocular eye pressure (IOP) with Applanation tonometry.
Gonioscopy -To assess type of glaucoma and management options
Assessment of the optic nerve .A non-invasive slit lamp biomicroscope is used to determine whether or not there are changes in the optic nerve in the diagnosis for glaucoma.
Assessment of retinal nerve fibre layer It is earliest site of damage. We have GDx VCC (Carl zeiss ,Germany) for earliest glaucoma detection.
Evaluation of a patient's visual field with Humphreys Perimeter, Zeiss Germany Glaucomatous damage produces characteristic defects in the visual field.

Glaucoma treatment seeks to decrease intraocular pressure and prevent damage to the optic nerve. Different types of glaucoma require different therapies to prevent further damage to the eye's structures. At the beginning of treatment, the doctor will generally recommend medication or a combination of medications for the specific condition.

Therapies may include:
Eye drops (or a combination of eye drops and pills) to reduce intraocular pressure. Several different classes of glaucoma medications are available to provide pressure reduction including beta blockers, prosaglandin analogues, alpha adrenergic agaonists, miotic, epinephrine compounds, and oral and topical carbonic anhydrase inhibitors. These medications work by either reducing the rate at which fluid in the eye is produced or increase the outflow of fluid from the eye.
Laser treatment to open the drainage angle and reduce intraocular pressure.
Surgery to create a new passage for fluid drainage. Surgery is usually reserved for cases that cannot be controlled by medication and following appropriate laser treatment.

Regular diagnostic examinations by an ophthalmologist are the key to preventing loss of vision due to glaucoma. Ophthalmologists are medical doctors, specialists in eye care and trained to examine and treat eye diseases. Although there is no way to reverse damage, if glaucoma is diagnosed and treated early, blindness almost always is preventable.
What are the symptoms of glaucoma?

Although the blindness associated with this disease is preventable, more than one million people in the United States have some glaucoma-related vision loss. In most cases, glaucoma is asymptomatic (has no symptoms). By the time an individual experiences decreased vision, the disease is frequently in its latter stages. Since early warning signs of glaucoma are rare, it is important --- especially for those at risk --- to have medical eye examinations at appropriate intervals, as described in this section.

Those who have chronic glaucoma may not be aware of any symptoms because the disease develops slowly and patients rarely notice loss of peripheral vision.
Those who have an acute form of glaucoma may develop severe symptoms because ocular pressure rises quickly and they may experience:

Blurred vision, especially at night
Halos or rainbows around lights
Severe headaches or eye pain

The eye has an internal pressure created by production of a clear fluid called aqueous humor. This fluid circulates through the eye and exits through the anterior chamber angle and ultimately drains into the blood stream. In glaucoma, the aqueous humor outflow is obstructed, resulting in increased eye pressure and, eventually, optic nerve damage.

Eyedrop Tips
Prescription eye drops for glaucoma help maintain the pressure in your eye at a healthy level and are an important part of the treatment routine for many people. Always check with your doctor if you are having difficulty.

Follow your doctor's orders.
Be sure your doctor knows about any other drugs you may be taking (including over-the-counter items like vitamins, aspirin, and herbal supplements) and about any allergies you may have.
Wash your hands before putting in your eye drops.
Be careful not to let the tip of the dropper touch any part of your eye.
Make sure the dropper stays clean.
If you are putting in more than one drop or more than one type of eye drop, wait five minutes before putting the next drop in. This will keep the first drop from being washed out by the second before it has had time to work.
Store eye drops and all medicines out of the reach of children.

Start by tilting your head backward while sitting, standing, or lying down. With your index finger placed on the soft spot just below the lower lid, gently pull down to form a pocket.

Let a drop fall into the pocket.

Slowly let go of the lower lid. Close your eyes but try not to shut them tight or squint. This may push the drops out of your eye.
Gently press on the inside corner of your closed eyes with your index finger and thumb for two to three minutes. This will help keep any drops from getting into your system and keep them in your eye, where they are needed.
Blot around your eyes to remove any excess.
If you are still having trouble putting eye drops in, here are some tips that may help.

If Your Hands Are Shaking

Try approaching your eye from the side so you can rest your hand on your face to help steady your hand.
If shaky hands are still a problem, you might try using a 1 or 2 pound wrist weight (you can get these at any sporting goods store). The extra weight around the wrist of the hand you're using can decrease mild shaking.

If You Are Having Trouble Getting The Drop Into Your Eye

Try This. With your head turned to the side or lying on your side, close your eyes. Place a drop in the inner corner of your eyelid (the side closest to the bridge of your nose). By opening your eyes slowly, the drop should fall right into your eye.

If you are still not sure the drop actually got in your eye, put in another drop. The eyelids can hold only about one drop , so any excess will just run out of the eye. It is better to have excess run out than to not have enough medication in your eye.

Having Trouble Holding Onto The Bottle?
If the eye drop bottle feels too small to hold (in cases where a dropper isn't used and the drop comes directly from the bottle), try wrapping something (like a paper towel) around the bottle. You can use anything that will make the bottle wider. This may be helpful in some mild cases of arthritis in the hands.

Assistive devices are available to help you put in your eye drops.


Near Risk Care Hospital, Near Makhamali Talao, LBS Marg, Thane (West) - 400 601, Mumbai, Maharashtra, India.
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