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April 2011
Do You Have Glaucoma?
Dr Binita Thakore
 
Glaucoma is the second leading cause of irreversible blindness the world over.  4.5 in every 100 people have it. Isn’t it time you knew if you have it?

Glaucoma is not the name of an eye disease by itself. It refers to a group of eye diseases that gradually steal your sight without warning - and often without symptoms. Vision loss is caused by damage to the optic nerve. This nerve acts like an electric cable with over a million wires and is responsible for carrying the images we see to the brain. High eye pressure is the main cause of optic nerve damage.

Causes of Glaucoma
A clear liquid called the aqueous humor flows in and out of the eye. This liquid is not part of the tears on the outer surface of the eye. You can think of the flow of aqueous as a sink with the tap turned on all time. If the drainpipe gets blocked, water collects in the sink and pressure within the inner eye increases, which can damage the optic nerve. Once the optic nerve gets damaged, a person loses vision that can never be regained. If the treatment of glaucoma is imperfect, a person can continue to lose vision.

Types of Glaucoma
There are numerous types of glaucoma:
  • Primary open angle glaucoma is the most common glaucoma the world over. The “drainpipe” or drainage angle of the eye becomes less efficient with time, and pressure within the eye gradually increases.
  • Primary angle closure glaucoma is a common glaucoma in India.Here the drainage angle gets blocked and the liquid cannot reach the drainage angles to leave the eye, so the pressure in the eye increases.
  • Congenital glaucoma is seen in infants and children. The drainpipe may have been incorrectly “manufactured”. Since the eye of an infant is more elastic, it increases in size and becomes white in colour.
  • There are other conditions like injuries to the eye, some drugs and diseases that can block outflow channels and cause secondary glaucoma. Patients with asthma and allergic skin and eye diseases often use inhalers, skin creams or eye drops containing steroids that can cause glaucoma. Persons who have undergone multiple eye surgeries are also at high risk.
Diagnosis of Glaucoma
Glaucoma can steal vision so quietly that the patient can be unaware of trouble until the optic nerve is badly damaged.

Because no symptoms occur, the best way to diagnose this disease is by periodic medical eye examinations. Some patients do have blurred vision, severe pain, can see rainbow haloes around lights or have nausea and vomiting with headaches.

Are You at Risk?
  • Do you have a family history of glaucoma?
  • Do you wear thick glasses?
  • Are you a diabetic?
  • Have you used steroid medications?
  • Have you had an eye injury or surgery in the eye?
  • Are you more than 35 years of age?

Treatment of Glaucoma
In most situations, glaucoma cannot be cured. Treatment is given to preserve the existing vision. This means that vision cannot be improved.

A complete glaucoma examination is necessary before any treatment plan is made.
  • In eyes with narrow angle glaucoma, lasers are done first to preserve the angle opening.
  • In patients with open angle glaucoma, eye drops are given to lower eye pressure.
  • For persons in whom glaucoma cannot be well controlled with these simple measures, there are several different operations and laser treatments available.

Dr Binita Thakore is Sr.Consultant Ophthalmologist and Glaucoma Specialist at Apollo Hospitals, Ahmedabad


    
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