Glaucoma

Preserving Vision Through Early Glaucoma Detection and Expert Management

Understanding Glaucoma: The Silent Thief of Vision

Our eyes help us connect with the world around us — from the faces of loved ones to the beauty of everyday life. But not all eye diseases give us an early warning. Glaucoma is one such condition. Often called the “silent thief of sight,” it can gradually damage your vision without causing pain or symptoms until it’s too late.

About Glaucoma

Glaucoma is a group of eye conditions that damage the Optic Nerve, the health of which is vital for good vision. In glaucoma there is a progressive and irreversible damage to the optic nerve which is the nerve of the eye responsible for vision and which, if untreated, can lead to blindness. This damage is often caused by an abnormally high pressure in your eye.

Glaucoma is one of the leading causes of blindness for people over the age of 60. It can occur at any age but is more common in older adults.

We need a certain amount of pressure in the eye to maintain its shape. There is a balance between the production and drainage of fluid which maintains the shape. Any increase in fluid production or an obstruction of the drainage causes a raise in eye pressure.

In the majority of cases, vision loss occurs painlessly and so gradually that most people do not realize they have a problem until substantial damage has occurred. Peripheral vision (at the edges) is usually lost first, especially the field of vision near your nose. As larger areas of your peripheral vision fade, you may develop “Tunnel Vision” — vision that has narrowed so you see only what is directly in front of you, like looking through a railroad tunnel.

Glaucoma is fast emerging as a major cause of blindness in India.

Outsmarting Glaucoma

It is necessary that the following categories of patients undergo a basic screening test for glaucoma since in the majority of cases there are no symptoms at all:

All individuals above the age of 40 years
Diabetic patients
Anyone who has a family history of glaucoma, in particular siblings and children above the age of 35 years of known glaucoma patients
High myopes — patients who have high minus power glasses
Anyone with eye complaints like:

Diagnostic Tools Available at Our Centre

The following instruments help detect the disease and track its progression early, which aids us in better patient management:

Intraocular pressure measurement (Applanation Tonometer, Perkins Tonometer, Non-Contact Tonometer)
Gonioscopy to examine the angle of the eye
Humphrey Field Analyser (HFA) — the gold standard for visual field analysis
Optical Coherence Tomography (OCT) of the Optic Nerve Head

Our Treatment Protocol

Once a patient is diagnosed with glaucoma, our doctors will discuss the various treatment options
In most cases the first line of treatment is eye drops to reduce the eye pressure
Frequent follow up visits are required usually every 3–6 months
One important point to note here is that treatment is life-long. The Glaucoma specialist will adjust the medication according to the clinical findings at each follow up visit. Since in a majority of patients there are absolutely no symptoms, the importance of lifelong treatment has to be stressed.
In patients who are diagnosed with angle closure Glaucoma or Narrow angles — which means the space between your iris (the coloured part) and cornea (the clear outer layer) is too small — a Laser Peripheral Iridotomy (LPI) may be advised.
In LPI, a laser beam is used to create a tiny hole in the iris. The extra fluid can drain and relieve pressure.
In advanced Glaucoma cases not responding to drops, patients might be advised to undergo a surgery called Trabeculectomy. This procedure creates a new pathway for fluid inside the eye to be drained. It is done as an outpatient procedure in the operating room.

Normal vs Glaucoma Vision

Below are images of the field of vision of a Normal patient and one with Glaucoma. As you can see, there is a “Tunnel Vision” pattern in Advanced Glaucoma.

Understanding the Types of Glaucoma

It helps to know that there are different types of glaucoma, each with its own cause and treatment approach:

Primary Open-Angle Glaucoma (POAG): The most common form, with slow, painless loss of vision.
Angle-Closure Glaucoma: Less common but more serious. It can develop suddenly and may be painful.
Normal-Tension Glaucoma: Even with normal eye pressure, optic nerve damage occurs.
Congenital Glaucoma: Seen in infants or children, usually diagnosed early.
Secondary Glaucoma: Caused by another condition like trauma, inflammation, or steroid use.

Can Glaucoma Be Prevented?

While glaucoma cannot always be prevented, early detection can stop or slow vision loss. You can reduce your risk by:

Scheduling regular comprehensive eye exams
Managing health conditions like diabetes and high blood pressure
Using prescribed eye drops consistently
Wearing protective eyewear to avoid injury
Avoiding self-medication, especially steroids

What to Expect During a Glaucoma Test

During your glaucoma check-up, your ophthalmologist may perform the following:

Visual Field Test - to assess peripheral vision
Optical Coherence Tomography - to analyse Optic nerve head
Pachymetry – to measure corneal thickness
YAG Laser Peripheral Iridotomy
Gonioscopy – to evaluate the drainage angle

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