A clear fluid called the Aqueous humor circulates continuously within the eye. Produced behind the iris, it flows forwards through the pupil and drains out of the eye through a meshwork of drainage channels. The amount of fluid produced inside the eye, balances the amount of fluid that flows out of the eye thereby keeping pressure within the safe range. Glaucoma (KALA-MOTIA) is a group of disorders wherein the pressure of the fluid inside the eye, called Intraocular Pressure (IOP*) rises to such a level that it damages the delicate structures of the eye specially the nerve of sight (Optic Nerve). Of all the conditions prevailing in the human eye, glaucoma is one of the most threatening ones. Glaucoma is also known as a ‘silent snatcher of vision’ as it has often no symptoms and may go unnoticed in the early stages.
Average Intra-Ocular Pressure (IOP) in adults is 16mmHg. The range varies from 9mmHg to 21mmHg. If the pressure is consistently above 21mmHg, the chances of eye damage are probably around ten percent. When the pressure is above 26 mmHg, the likelihood increases to about fifty percent. If the IOP persists above 30 mmHg, the damage will definitely occur.
The Intraocular Pressure is different and independent of blood pressure. Don’t confuse it to be related to tensions of day-to-day life.
The two main categories of glaucoma are open-angle glaucoma and angle-closure glaucoma. Open-angle glaucoma is the most common form and develops gradually, while angle-closure glaucoma is more acute and can be triggered by a sudden blockage of the eye’s drainage angle. Within these categories, other variations, such as normal-tension glaucoma, secondary glaucoma, and congenital glaucoma, exist, each demanding unique approaches to diagnosis and management. Understanding the different types of glaucoma is crucial for timely detection, intervention, and preserving the vision of those affected.
About Open-angle Glaucoma
Open-angle glaucoma is a chronic eye condition characterized by gradual and painless damage to the optic nerve, which is responsible for transmitting visual information to the brain. It occurs when the drainage channels within the eye become less efficient at draining aqueous humor, the fluid that maintains eye pressure. This leads to an increase in intraocular pressure, damaging the optic nerve over time and resulting in a gradual loss of peripheral vision.
Since open-angle glaucoma typically progresses silently and without noticeable symptoms until advanced stages, regular eye examinations are crucial for early detection and management. If left untreated, it can eventually lead to irreversible blindness. It accounts for over 90% of all Glaucoma cases.
About Angle-closure Glaucoma
This is the second most common type of Glaucoma. Angle-closure glaucoma, also known as acute or narrow-angle glaucoma, is a serious eye condition characterized by a sudden and rapid increase in intraocular pressure due to the blockage of the drainage angle within the eye. This blockage prevents the aqueous humor (fluid in the eye) from draining properly, leading to a buildup of pressure that can damage the optic nerve and result in vision loss if not promptly treated. It requires immediate medical attention to relieve the pressure and prevent vision impairment.
About Normal Tension Glaucoma
Normal Tension Glaucoma (NTG), often referred to as low-tension glaucoma, is a subtle yet serious eye ailment. Unlike typical glaucoma, NTG damages the optic nerve even with normal eye pressure. This inconspicuous rise in pressure progressively impairs peripheral vision, escaping early notice as central vision remains intact. Regular eye examinations are vital to catch NTG early, allowing for interventions like eye drops, laser therapy, or surgery to mitigate further damage. By understanding NTG, individuals can actively protect their vision and avert potential irreversible blindness. The cause of Normal Tension Glaucoma is not fully known.
About Secondary Glaucoma
Secondary glaucoma is a type of glaucoma characterized by increased intraocular pressure (IOP) resulting from underlying medical conditions, ocular injuries, or certain medications. Unlike primary open-angle glaucoma, which usually develops gradually without obvious triggers, secondary glaucoma is typically linked to identifiable causes such as eye trauma, inflammation, certain systemic diseases like diabetes or hypertension, intraocular tumors, or prolonged use of corticosteroid medications. They can be further classified as Congenital, Pigmentary, Neovascular, Lens Induced, or Malignant Glaucoma.
Early detection and effective treatment are crucial to managing glaucoma and preserving vision. There are various treatment options available, ranging from medications to surgical interventions, each tailored to the specific type and severity of the condition. These treatments aim to lower IOP and prevent further damage to the optic nerve, thereby slowing the progression of the disease.
Regular monitoring by an ophthalmologist is essential to determine the most suitable treatment plan for each individual, considering factors such as the patient’s overall health, medical history, and lifestyle. By addressing glaucoma promptly and effectively, individuals can significantly enhance their chances of maintaining good visual health and quality of life.
Medical Treatment for Glaucoma
The primary treatment for glaucoma involves using eye drops to lower eye pressure. These drops work by either reducing the production of fluid in the eye or enhancing its drainage. It’s important to apply the drops correctly and consistently according to your doctor’s instructions. In some cases, oral tablets might also be necessary.
While using these medications, there’s a chance of experiencing side effects. Some common side effects include stinging, redness, temporary blurred vision, or headaches. These usually fade after a few days. Uncommon side effects could include changes in heart rate and breathing. Remember, never stop or alter your medication without consulting your eye specialist. Regular eye check-ups and tests are vital to monitor any glaucoma changes. Occasionally, oral medication might lead to tingling in extremities, drowsiness, appetite changes, digestive irregularities, or kidney stones. If you suspect any side effects, promptly inform your healthcare provider.
Laser Treatment for Glaucoma
Laser surgery is effective for some types of Glaucoma. In chronic open angle Glaucoma, the drain itself is treated (trabeculoplasty), and the laser helps to reduce the medications to control the pressure. In angle-closure Glaucoma, a hole is made in the iris (Laser iridotomy) to restore the free flow of aqueous fluid.
These laser procedures offer effective and minimally invasive options for managing glaucoma, but suitability varies per patient. You can contact us for personalized treatment recommendations.
Trabeculectomy Surgery for Glaucoma
In advanced cases, surgery (trabeculectomy) is necessary to control Glaucoma. We use miniature instruments to create a new drainage channel for fluid to leave the eye, thus lowering the pressure in advanced cases. If surgery fails, special Glaucoma valves can be implanted. Fortunately, serious complications of modern Glaucoma surgery are rare. Surgery for Glaucoma would be recommended only if the medicines fail to prevent damage to the optic nerve. Whatever may be the approach, the objective of the treatment is to lower the eye pressure to a level at which optic nerve damage does not develop or worsen.
Ahmed Glaucoma Valve Implant:
In individuals suffering from glaucoma, the accumulation of fluid known as aqueous humor raises the pressure within the eye, leading to potential vision impairment. To tackle this issue, the Ahmed valve comes into play as a miniature implant that helps lower the intraocular pressure (IOP).
The Ahmed valve represents a specific type of implant designed to create an alternative route for the aqueous humor fluid to exit the eye, thereby relieving pressure on the optic nerve and averting further deterioration of eyesight. During the surgical procedure, an ophthalmologist inserts a tiny silicone tube at the front of the eye. This tube is connected to a small device called a plate, discreetly positioned beneath the conjunctiva—a clear layer covering the eye’s white portion.
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