What is glaucoma?
"Glaucoma is a term describing a group of ocular (eye) disorders that result in optic nerve damage, often associated with increased fluid pressure in the eye (intraocular pressure) (IOP)."
This condition also called Silent thief of vision, is one of the leading causes of avoidable blindness among general population. This affects 1-2% of general population and awareness among people is very low. This has two main type, one is open angle glaucoma where the optic nerve damage is slowly progressing and other type is angle closure glaucoma which can cause sudden blindness. Both these cause irreversible damage to optic nerve and loss of vision, thus making it all the more important to detect it early.
Who are at risk of developing glaucoma?
The risk factors for glaucoma are:
Age: Most commonly it affects the people above 40 years of age but can occur at any age including infants and children.
High refractive error:Those with thick glasses are at higher risk of glaucoma. Those with high plus number can develop sudden loss of vision due to angle closure glaucoma which can be easily treated by doing a tiny hole in the iris (Laser Iridotomy). If you have undergone refractive surgery like Lasik, you are still very much susceptible for developing glaucoma.
Previous eye Surgery or Trauma: any previous surgery or trauma in your eye increases risk of developing glaucoma.
Family history: If your first degree relative like parents, siblings have glaucoma, then your chance of developing glaucoma increases.
Steroid usage: The prolonged use of steroid containing drops increases the chances of glaucoma. Hence indiscriminate use of the over the counter eye drops without doctor’s advice should be avoided.
How to prevent glaucomatous vision damage?
The best way to prevent the damage is to detect it early by having regular comprehensive eye check-up every year after 40 years of age. Those with family history of glaucoma should have their comprehensive eye check-up from the age of 35 years.
How glaucoma is diagnosed?
The glaucoma is diagnosed looking at your intraocular pressure, optic nerve cupping and changes in visual field and or Retinal nerve fibre thickness evaluation.
The Intra Ocular Pressure (IOP) is single most important (not the only) parameter in screening for glaucoma and is part of regular eye examination at most of the standard eye hospitals. It’s always important to ask your doctor about intraocular pressure when you go for an eye check-up. However it’s also important to note that in some small number of cases the IOP can be normal like in Normal Tension Glaucoma. The next step is fundus examination wherein any glaucomatous damage to Optic nerve is looked for. The fundus examination is also a part of regular eye examination at most of the hospitals. If there is a suspicion of glaucoma, your doctor may advise further tests.
What are the tests done to evaluate glaucoma?
Part from vision and refraction testing, your intraocular pressure, fundus examination, fundus photography may be done for documentation. The specialized tests include Gonioscopy to check the angles, measure corneal thickness (Pachymetry) for accurate assessment of IOP, Visual field testing (Perimetry) and OCT for Retnal Nerve Fibre Thickness analysis. These tests may have to be repeated at regular intervals to monitor the progression of glaucoma.
Is there any cure for glaucoma?
The steroid induced glaucoma in some cases may resolve completely after stopping usage of the medication. In some cases of angle closure glaucoma Laser Iridotomy may prevent further progression. However in most cases glaucoma is a chronic eye disease which may need lifelong treatment.
What are the treatment options for glaucoma?
Aim of glaucoma treatment is to prevent further damage. No treatment can reverse the damage already caused. The treatment options include Eye drops, Lasers and Surgery. The appropriate treatment option will be discussed by your treating doctor based on man parameters.