Glaucoma Treatment In Mumbai

Glaucoma and its Causes

Glaucoma is a condition which arises due to the increased pressure inside the eye, causing subsequent damages to the optic nerve (in eye) resulting in a gradual yet silent impairment of vision.

Glaucoma is also known as a ‘Silent thief’ who steals one’s sight slowly without showing out any obvious symptoms. This condition usually presents without any pain, redness or evident visual symptoms in early stages, but once the advanced stage is reached and the patient realizes that his vision has got hampered, it will be so hard to get it repaired.

That is the major reason as to why glaucoma should be diagnosed as early as possible before resulting in irreversible complications.

Optic nerve takes the image which falls on Retina to our brain and converts them into information. This structure is formed with millions of nerves. Behind our cornea we have anterior chamber which consists of a clear fluid useful in making a clear picture on retina and feeds the nearby tissues. This fluid is continuously produced inside the eye and to balance that an equal amount of it leaves the eye through a drainage space at where cornea and iris meet. If this gel does not flow out of the eye properly, it can pressurize the optic nerves resulting in Glaucoma.

This is the most common cause of Glaucoma and named as ‘Open-angle Glaucoma’. However, this condition can also arise in a person who does not have the eye pressure named as ‘Normal-tension Glaucoma’. This could happen to a person whose space between cornea and iris is very narrow and blocked, known as ‘Angle-closure Glaucoma’. Glaucoma can be carried from genes and this is known as ‘Congenital Glaucoma’ or may be caused as side effects of some other eye disease or surgery, known as ‘Secondary Glaucoma’.

Symptoms of Glaucoma

This gives no symptoms at its early stages. The vision will have small black fixed dots initially and become gradually large. The side image vision gradually disappears until total vision is lost with an extremely damaged optic nerve. However, following symptoms may give an indication of Glaucoma:

• Continuous redness in the eyes
• Pain in the eyes or forehead
• Severe pain with Vomiting and nausea
• Blurred or double vision
• A sensation of decreased or restricted field of vision.
• Feeling of blind spots or missed spaces when you look at something.

When to see the doctor?

It is not advisable to wait until you see clear symptoms of Glaucoma as they often have no symptoms during the early stage.

However, if you are above 40 years or if your family has a history of Glaucoma or other eye diseases or if you have done any eye related surgeries, it is advisable to be cautious of your eyes. You should visit your eye specialist to check your eye condition at least once in two years.

Tests performed to detect Glaucoma

Your doctor will perform number of tests to carefully examine the eyes.

• Visual Acuity test – This measures how well your eyes can see things at various distances.
• Visual Field test – This measures how good is yourperipheral vision.
• Non Contact Tonometry – This is a test to check the eye pressure using Tonometer.
• Pachymetry – This measures how thick is the cornea of the eye using an ultrasonic wave tool to get corrected eye pressure or Intra Ocular Pressure (IOP).
• Gonioscopy – The doctor examines the drainage space physically using a magnifying lens.
• OCT – This is a specialized non-invasive technique which is used for rapid scanning of the eye. Being able to visualize the exact damage caused to the optic nerve, this diagnostic test helps the doctor in screening, detecting early glaucoma and grading the stage of glaucomawhich is highly valuable to decide the type of treatment and follow-up.

Treating Glaucoma

Remember that Glaucoma treatment do not bring back the lost vision but it controls further blurring and reduces the pace of it. Glaucoma can be treated with medicines or surgery. Treatment method is chosen by the doctor depending on severity of your condition.

Medications

Your doctor would recommend eye drops or oral medicines to take regularly for a specific period. These medicines help you to lower the eye pressure, reduce the production of liquid by the eyes or drain the liquid from the eyes.

Complications of using medicines would be

• Allergy for using with other medicine you use.
• Headaches
• Redness in eyes, itchiness and burning
• Breathing difficulties
• Blurred vision
• Dry mouth
• Heart beat rate changes
• Eyelash growth

Surgery for Glaucoma

This can be a laser procedure or conventional surgery yet again depending on the severity of your condition.

Laser procedure – In this method of surgery, the drainage space is stretched using a highly intensive light beam. You will be made to sit by a laser machine.The eye is made numb to make you comfortable. Your doctor points laser to the spot and makes consistent burns to expand it. This helps in releasing the blocked liquid to flow out and it also reduced the liquid production.

Your doctor would recommend continuing certain medications in future as laser surgery cannot be considered as a permanent solution. It is reported that people start to complain about Glaucoma after about 5 years of laser surgery.

Microsurgery procedure – In this surgery a new path is created to release the fluid from the eyes. This is only done in patients after failed medication and laser surgery or in patients with advanced glaucoma.

Here, the patient will be taken inside the operation theater, medicines are given to relax, eye is made numb through an injection and then doctor does the surgery. Tiny tissue is removed between iris and cornea to create a new path for the liquid to flow out. This procedure is called Trabeculectomy.

Eye drops and medicines will be recommended to refrain from inflammation and infections. You need to be careful of the eyes for several weeks. This surgery helps in reducing the eye pressure and recommended if some other surgery has been performed on the eye before.

The above two surgeries are the common ones but there are other procedures might be to insert a small tube channel into the eye to enhance drainage. These valves or glaucoma drainage devices are usually required in complicated cases like failed trabeculectomy, secondary glaucoma, ICE syndrome etc.

Risks and Complication in surgery

• Low eye pressure – Eye pressure might drop more than the level required. This will lead the fluid to gather atthe backside of retina and brings more complication. This condition may be a temporary one just after the surgery.
• Cataract – Glaucoma surgeries could trigger cataract formation and additional surgeries.

However, treating is always advisable as untreated Glaucoma ends up in total vision loss.