Glaucoma Brochure
What is Glaucoma?
It is a disease that damages eye's optic nerve due to increased fluid (Aqueous Humor) pressure; known as intra ocular pressure (IOP).
It is also called as "kala pani or kachbindu". This is a silent thief of vision as patient do not realize that one has glaucoma until and unless it reaches to advance stage.
And the damage caused by glaucoma is irreversible; treatment can be given only to prevent further damage; vision which has lost once can never be restored back.
Meet our Glaucoma specialist, Dr. Nitin Deshpande
He has done his long term fellowship From Arvind Eye Institute, Madurai and has more than 15 years of expertise in all types of Glaucoma managements.
We are very proud to announce him as one of the pioneers to introduce Micro Incision Glaucoma Surgery (MIGS) to India
Signs and Symptoms of Glaucoma:
- Most of the patients do not show any symptoms of glaucoma.
- Loss of side (peripheral) vision can be noted while crossing roads. One can miss the vehicles coming from side.
- Eye pain
- Blur vision or sudden loss of vision
- Headache which are not relieved even after taking pain killers.
- Nausea and Vomits.
- Colour Haloes seen around lights specially at nigh time.
- Redness of eye usually happens with severe eye pain.
- Large Eye size
- Difficulties in identifying shades of yellow and blue colours
Causes of Glaucoma:
- Hereditary or Genetic Glaucoma
- Blocked or restricted drainage of eye fluid (Aqueous Humour)
- Long term use of medications such as oral or Topical Steroids
- Reduced blood flow to optic nerve this nerve once damaged, one can lose vision completely and go blind
- High BP and uncontrolled long-term Diabetes
- Past injuries to Eye
- Cataract which are not operated for longer time
- Congenital (child is born with Glaucoma)
Risk Factors in Glaucoma:
- Family history of Glaucoma: patient whose parents or relatives or siblings have glaucoma are at the highest risk to develop glaucoma.
- High Intra ocular pressure (IOP) like our body has pressure, i.e., BP, eye has its own pressure.
- Age above 50 years: age related changes in eyes can lead to Glaucoma.
- Systemic history such as Diabetes, Hypertension, Heart disorders, Sickle cell anemia: even if all of these illness are well controlled, they can cause glaucomatous damage if they are long term.
- High minus or high plus refractive errors
- Previous eye injuries or head injuries
- Use of oral or topical Steroids for long time.
Types of Glaucoma:
- Open Angle glaucoma
- Angle Closure Glaucoma
- Normal Tension Glaucoma
- Congenital Glaucoma
- Neovascular Glaucoma
- Pseudo exfoliative Glaucoma
- Secondary Glaucoma
Treatment of Glaucoma:
- Medications
- Lasers
- Surgery
- Either one or combination of above mentioned treatment types
- Plan of treatment varies patient to patient. It is decided by glaucoma specialist doctors depending upon patients age, severity of glaucoma, type of glaucoma, amount of damage happened already to eyes, range of eye pressure etc.
Process followed at Shree Ramkrishna Netralaya to diagnose Glaucoma:
- Every patient is checked by Optometrists for eye pressure by NCT ( non-contact tonometer which is used to measure eye pressure), vision and refraction along with detail history taking.
- Normal range of IOP is 10mm Hg to 21 mm Hg.
- If Iop is outside the normal range, its verified by the gold standard Goldman applanation tonometer( another; most accurate instrument to measure eye pressure).
- If necessary, Optometrists put dilating eye drops for the checkup of retina and optic nerve head.
- Ophthalmologists ( Glaucoma specialist) then examine patient with slit lamp (to check internal eye health).
- Depending on upon eye conditions and patient's complaints, further tests like perimetry, Ocular coherence tomography , Electro retino gram, Fundus Photo can be advised.
Prevention of prognosis of Glaucoma:
- Regular eye examinations: both undiluted and dilated.
- Follow prescribed medicinal schedule religiously.
- Control of systemic illnesses such as diabetes, hypertension etc.
- Avoid use or overuse of any drugs without medical advises.
Facilities at Shree Ramkrishna Netralaya
CIRRUS HD OCT
HFA 3 (First in Thane)
VISULAS 532s Green Laser
VISUCAM 524 (First in Maharashtra)
Eye Screening At
Shree Ramkrishna Netralaya
Latest versions of all diagnostic instruments of Glaucoma:
- Non-contact tonometer by Zeiss Germany: To check eye pressure without direct contact to eye.
- Perkins applanation Tonometry: handheld device to check eye pressure, useful for physically challenged individuals.
- Goldman applanation Tonometry: gold standard instrument to measure eye pressure, this gives most accurate value of eye pressure.
- Perimetry by Zeiss, Germany: to check side vision of eye.
- HD OCT by Zeiss Germany (Ocular Coherence Tomography): to check early damage to optic nerve layers and also to measure eye angles accurately.
- Fundus cameras Germany: To document Optic nerve head picture.
- Dyopsis ERG ( Electro Retino Gram): to note early damages in eye cells due to glaucoma.
- 4 Mirror Gonioscopy: to check detail structures in angle of the eye.
- Anyone who has his family member suffering from Glaucoma, is at highest risk to develop glaucoma. In that case, glaucoma specialist doctor may want to perform Oct and ERG tests to note early damages in eye cells.
Lasers in Glaucoma:
- Visulas Yag Peripheral Iridotomy by Zeiss Germany
- SLT ( Selective Laser Trabeculectomy)
Surgeries in Glaucoma:
- Micro incision glaucoma surgery (MIGS) : introduced In SRN for the first time all over India.
- Trabeculectomy
- Surgical Yag PI
- Ahmed Valve
Carl Zeiss Cirrus Hd Oct
Used for measuring thickness of retinal nerve fiber layer, the tissue first damaged by glaucoma. Can effectively differentiate patients with early glaucoma from normal subjects
Humphrey's Perimeter
The purpose of visual field testing or perimetry, is to provide information critical to:
Diagnosing ocular disease, especially glaucoma
Evaluating neurological disease.
Monitoring the progress of ocular and neurological disease.
Ahmed Glaucoma Valve
The device works by bypassing the trabecular meshwork and redirecting the outflow of aqueous humor through a small tube into an outlet chamber or bleb. The IOP decreases from around 33 to 10 mmHg by removing aqueous on average 2.75 micro liters / min.
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Selective Laser Trabeculoplasty
Selective Laser Trabeculoplasty". This is a laser procedure used to treat glaucoma by reducing the pressure in the eye. This therapy is reimbursed by Medicare and many other insurance providers, which minimizes your out-of-pocket expenses.
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For accurate and reproducible corneal thickness measurement.
Gonioscopy : For visualizing angles in glaucoma
Applanation Tonometry : Gold standard for measuring intraocular pressure