Should you be worried about Glaucoma? Yes, if you are over 40.
Everyone over 40 years of age should get an eye examination to rule out #Glaucoma though it can affect anybody including children and even infants. People more at risk are those who fall in one or more of the following groups
Over 40 years old
Have high Intraocular Pressure (IOP)
Suffer from certain medical conditions such as Diabetes, High Blood Pressure, Cardiac diseases, Migraine and Sickle Cell Anemia
Have a family history of Glaucoma
Suffer from high degree of nearsightedness or farsightedness
Have been on steroid medications for long, particularly eyedrops
Have suffered an eye injury or have had a complex eye surgery
#Glaucoma is a condition of the eye in which the optic nerve gets affected. Glaucoma is called a “Sneak Thief of Sight” since the most common form of Glaucoma (Open Angle Glaucoma) does not present many symptoms in the early stages making it hard to detect early but if not detected Glaucoma may eventually lead to blindness. Vision loss due to #Glaucoma cannot be reversed so early detection is crucial.
Process of #Glaucoma detection starts with a routine eye examination which includes
Visual Acuity Test: Vision is tested with eye charts
Non Contact Tonometry: The intraocular pressure is checked with a Non-Contact Tonometer
Slit lamp examination: Eyes are examined under magnification. This helps in optic nerve evaluation. If required, eyes are dilated to get a detailed view of retina.
Based on the findings from the routine examination, if the doctor feels that you may be a glaucoma suspect, next set of tests are conducted
#Applanation Tonometry: This is the gold standard for measuring intraocular pressure.
#Pachymetry / Central Corneal Thickness Test: In this the Corneal thickness is measured. Corneal thickness is important because it can mask an accurate reading of Intraocular Pressure - actual IOP may be underestimated in patients with thinner CCT, and overestimated in patients with thicker CCT. IOP reading is corrected based on the findings from this test.
#Gonioscopy: This enables the doctor to check if the drainage of the aqueous humour (intraocular fluid) is hampered by angle structures.
#Perimetry / Visual Fields Test: This test provides a measure of the peripheral vision which is typically the first casualty of Glaucoma
In addition to the above, certain tests may be required to confirm the diagnosis of Glaucoma and establish a baseline for future follow-ups, these may include one or more of the following
Optic Disc Photograph: This helps in picking up structural changes and determining change over a period.
#OCT (Retinal Nerve Fibre Layer Analysis) OR Heidelberg Retina Tomograph (HRT): These pick up early structural changes in the optic nerve via fast and reproducible scans. These are helpful in picking up Glaucoma early and are also used to monitor progression.
As stated earlier, vision loss due to Glaucoma cannot be reversed. Glaucoma treatment is aimed at slowing down or stopping the progression of the disease and this is achieved by lowering the Intraocular Pressure. In the early stages, most Glaucoma responds well to eye drops - some decrease the fluid production, others increase the filtration to lower the intraocular pressure. Sometimes oral medicines may also be prescribed. In some cases, Laser treatments (Laser peripheral Iridectomy and Laser Trabeculoplasty) are required. For cases that do not respond to medical or laser therapy, Trabeculectomy surgery is an option which creates a new opening for the fluid to leave the eye.
For complex/complicated cases of Glaucoma, Shunts/Valves are the treatment options. Some of the recent surgical advances are in minimally invasive glaucoma surgery (MIGS) using implantable devices that can be combined with cataract surgery to control IOP. The most used is the ‘i-stent’ inject which is being used in clinical trials, the results so far seem to be promising.
Have more questions about Glaucoma? Schedule a consultation with our Glaucoma Surgeon Dr. Smriti Jain
Dr Smriti Jain is one of the very few specialist Glaucoma Surgeons in Gurgaon. During her 20 years practice she has conducted numerous complex surgeries for Primary Open Angle Glaucoma, Angle Closure Glaucoma and Secondary Glaucoma. She can be consulted at the Krishna Netralaya centres in Gurgaon on Sohna Road and Golf Course Road.
Advanced Glaucoma Care at Krishna Netralaya includes Complete Diagnostics (Applanation Tonometry, Gonioscopy, Perimetry/Visual Field Test, Pachymetry/Central Corneal Thickness Test, OCT/Retinal Nerve Fibre Layer Analysis etc.), Medical and Laser Treatments, as well as Surgical Treatments (Trabeculectomy, Ahmed Glaucoma Valve Implantation etc.)