Glaucoma is a group of eye diseases in which the Optic Nerve (the bundle of nerve fibers that carries information from the eye to the brain) gets damaged and can lead to vision loss or blindness.

It is also known as “Kala Motia”. Optic nerve damage usually occurs in the presence of high eye pressure (high intraocular pressure); but it can also occur with normal or even less than normal eye pressure.

What Causes Glaucoma and Who Can Get It

Glaucoma is usually caused by too much fluid in your eyes. This fluid helps your eyes stay healthy and clear, but sometimes it doesn’t drain well and builds up pressure. This pressure can damage the nerves that carry images from your eyes to your brain.

Anyone can get glaucoma, but some people are more likely to get it than others. You may have a higher chance of getting glaucoma if you:

• Have high pressure in your eyes
• Have a family member who has glaucoma
• Have had an eye injury or surgery
• Use steroid medicines for a long time
• Have very nearsighted or farsighted eyes

Types of Glaucoma

• Open-angle glaucoma :-
  This is the most common form. The drainage angle where the iris meets the cornea is open, but the trabecular meshwork (the drainage system within the eye) becomes less efficient over time, leading to an increase in intraocular pressure
• Angle-closure glaucoma :-
  In this type, the drainage angle between the iris and cornea is closed or blocked, causing a sudden increase in intraocular pressure. This is considered a medical emergency
• Normal-Tension Glaucoma (NTG) :-
  In Normal Tension Glaucoma, optic nerve damage and vision loss occur despite normal intraocular pressure. The exact cause of this type is not fully understood, but factors such as reduced blood flow to the optic nerve may play a major role.
• Secondary Glaucoma :-
  Secondary glaucoma can be caused by eye injuries, inflammation, tumors, or other conditions that affect fluid drainage from the eye.
• Pigmentary Glaucoma :-
  Pigmentary Glaucoma occurs when pigment granules from the iris build up in the drainage channels of the eye, which leads to increased intraocular pressure and optic nerve damage.
• Exfoliative Glaucoma :-
  This type is associated with the shedding of material from the outer layer of the lens. The material can block the drainage angle, leading to increased intraocular pressure.
• Congenital Glaucoma :-
  This rare form of glaucoma is present at birth and is usually caused by an abnormal development of the eye's drainage system. It requires prompt medical attention.

How often should i get my eyes examined for Glaucoma?

• Every 3 - 4 years: After the age of 40 years, you should get an eye check for glaucoma, even if there are no symptoms, every 3-4 years.
• Every 1 to 2 years: If you have a family member with glaucoma or if you have diabetes or if you are on long term systemic steroids for some other disease, or if you have suffered a blunt eye injury in the past, you must get your eyes screened for glaucoma every 1-2 year
• Every 3-6 months: if you are diagnosed to have glaucoma Regular review is important and the intervals between review will depend upon the severity of visual loss and the extent of pressure control.
• Child or a newborn: A child having sensitivity to light or any eye that appears bigger or cloudier than usual, should be shown to an eye specialist to rule out congenital glaucoma.
• Even if the eyes appear normal and there is no family history of eye disease, we strongly recommend a regular eye check-up for children at the age of 3-4 years before they start school.

How We Diagnose and Treat Glaucoma

To find out if you have glaucoma, we will do some tests on your eyes. These tests will check:

• Pressure of your eyes
• Peripheral vision that is how well you can see things on the sides of your eyes
• How healthy your optic nerve is (the nerve that connects your eyes to your brain)
• How thick your cornea is
• How well your eye fluid drains
• We will also take pictures of your eyes to see if there are any changes or damage.

Based on the results of these tests, we will make a plan to treat your glaucoma. There are different ways to treat glaucoma, depending on how severe it is and what works best for you. Some of the options are:

• Eye drops or pills that lower the pressure in your eyes
• Laser therapy that makes small holes in your eye to help the fluid drain better
• Surgery that creates a new way for the fluid to leave your eye
• We will explain the benefits and risks of each option and help you choose the best one for you. We will also monitor your eyes regularly and adjust your treatment as needed.

Treatments for Glaucoma

The treatment of glaucoma aims to lower intraocular pressure (IOP) to prevent or slow down further damage to the optic nerve. The specific treatment plan depends on the type and severity of glaucoma. Here are some common glaucoma treatments:

Prescription Eye Drops: Eye drops increase the outflow of aqueous humor (fluid) from the eye, and reduce intraocular pressure or decrease the production of aqueous humor.

Oral Medications: In some cases when eye drops are not effective oral medications may be prescribed, particularly for certain types of glaucoma.

Laser Therapy

• Laser Peripheral Iridotomy (LPI): Used for angle-closure glaucoma, this procedure creates a small hole in the iris to improve drainage.
• Laser Trabeculoplasty: This procedure is often used for open-angle glaucoma and involves applying laser energy to the trabecular meshwork to enhance drainage.

Surgery

• Trabeculectomy: This surgical procedure creates a new drainage channel for the aqueous humor to reduce intraocular pressure.
• Minimally Invasive Glaucoma Surgery (MIGS): New surgical techniques that involve less tissue disruption than traditional surgeries.

Drainage Implants: Sometimes a drainage tube shunt may be surgically implanted to help drain excess fluid from the eye.

Regular Monitoring: Regardless of the treatment method, regular monitoring and follow-up appointments with glaucoma eye specialists are essential to assess the effectiveness of the treatment and make adjustments as needed.