Glaucoma is the most serious eyesight threatening condition of the eye. Is usually manifests as a painless gradual loss of vision. The lost vision can never be recovered. However, medical or surgical treatment can prevent or retard further loss of vision. Many a times it can be confused with a cataract which also manifests as a painless gradual loss of vision. The difference is that in the case of cataract, the loss of vision is fully recoverable by means of a simple surgery called Phaco.

1.What is Glaucoma?

Our eyes contain a clear fluid called aqueous humour, which is continuously produced in the eye to bath and nourish the structures inside it. The fluid normally drains out of the eye  through drainage canals in a fine meshwork located around the edge of the iris (the coloured part of the eye that surrounds the pupil). In people with glaucoma the fluid fails to drain due to some defect and thus increases the pressure inside the eyes called raised Intraocular Pressure (IOP) (or Tension)

2. How is Glaucoma detected?

Ophthalmologist can help you detect glaucoma by conducting examination of eye, tonometry. fundus examination and perimetry test.

3. When should you get the eyes checked?

· If you have a family history of glaucoma
· If you experience blurring of vision
· If you see haloes around light
· If you suffer from frequent headaches
· Frequent change of glasses due to decreasing eyesight

4. How does Glaucoma, if not treated in time, damage the eye?

If not treated, the risk of high intraocular pressure causing progressive damage to the optic nerve increases. Optic nerve carries the images from the eye to the brain. Damage to this can gradually reduce your field of vision, starting with loss of  peripheral or side vision. Ultimately this loss of vision may extend to larger areas of vision   and may lead to total blindness

5. What are the types of Glaucoma?

(a) Open Angle Glaucoma (Common) : Gets its name because the angle that allows fluid to drain out of the anterior chamber is open, but the fluid passes too slowly through the meshwork drain and pressure inside the eye rises. This type has no symptoms except painless gradual loss of vision. This is the most common presentation.

(b) Closed Angle Glaucoma (Uncommon) : Fluid continuously being produced by the eye is unable to flow out freely due to narrow drainage pathways. Total closure of the drainage pathway can cause a sudden build up of fluid and lead to increased pressure inside. In this patient may experience severe headache; blurring of vision and haloes around light, vomiting and redness of eye. This is a less common type of presentation.

6. Who are at risk? 

• Everyone over the age of 40 yrs.

• People with family history of glaucoma.

• Diabetics

• People with near sightedness (Myopia) for open angle type and far sightedness (hyperopia) for close angle type

7. Can Glaucoma be treated ?

Glaucoma is a chronic (long lasting) progressive condition. Any vision loss that has occurred, before glaucoma was diagnosed, cannot be reversed. Glaucoma medicines especially eye drops are effective in reducing intraocular pressure and control further deterioration of vision. However this is only a control and no cure for Glaucoma .

The medicine advised by the doctor should be used regularly for the rest of your life. You should schedule regular follow up appointment, so that intraocular pressure can be monitored. In case the pressure is not controlled with medicines, an operation can be done to create a new drainage to keep the intraocular pressure under control. Laser techniques can also be used to open the drainage channels to a limited extent.

Applanation  Tonometry is the most sensitive technique to detect the level of Intraocular Pressure (IOP), which is an indicator of Glaucoma

Visual Fields on Humphry Field Analyser (Sensitive indicator to monitor the progress of Glaucoma)