It is potentially blinding condition.
Many patients with glaucoma may be symptomless while other experiences sudden pain and redness.
Glaucoma is a disease which exhibits a characteristic optic neuropathy which may result in progressive visual field loss.
- Raised intraocular pressure secondary to reduced aqueous outflow through the filtration angle.
- Positive family history of glaucoma.
- Systemic disorders like diabetes, diseases for which steroids is a long main stay of treatment.
- Previous eye injury.
- Age people over the age of 40.
Classification of Glaucoma:
-Congenital (by birth or development) and acquired.
-Open angle and angle-closure glaucoma.
-Primary and secondary glaucoma.
Symptoms of Glaucoma:
- Depending on type of glaucoma the symptoms varies.
1) First upon and very important thing is that many times, glaucoma is a symptomless disorders.
2) Glaucoma may be unilateral or bilateral.
3) It causes slowly progressive, painless diminished vision as far as open angle glaucoma is concerned, patient looses peripheral vision, and if untreated there is irreversible severe damage to the visual field, patient sees as he/she is seeing through a tunnel; and further more loose all the vision.
4) Narrow angle glaucoma, or closed angle glaucoma produces sudden pain, Headache, dilated pupil, visual loss, halos around light, congestion, nausea and vomiting, it is called attack of glaucoma. The symptoms resolves after some hours but some part of permanent visual loss takes place.
5) In secondary glaucoma symptoms of eye pain, watering, redness is there as most of secondary glaucoma follows eye surgeries, trauma and symptoms of infection, inflammation is there.
6) Lense Induced Glaucoma: When the cataract matures a lot and still not operated then it looses some proteins called as phacolytic glaucoma and many times it is so hypermature that the pupil gets dilated and raises IOP called phacomorphic glaucoma. Timely cataract surgery is the key.
Important Diagnostic Tests
By the various tools IOP can be measured
Non contact tonometer
IOP having diarnal variation means changes with time, so IOP recording is an important factor.
After dilation of pupil, optic nerve head is examined by Direct / Indirect ophthalmoscopy /+90 D to record shape and colour of the optic nerve , Fundus photography and posterior segment OCT is important for this.Perimetry
With the equipment called perimeter the visual field of patient can be examined. It is a subjective test, documentation is needed for the fallow up examination.
It is done by a specialized lense called gonioscope to examiac drainage angle (the space between cornea and iris) is open or closed after putting Anaesthetic eye drop with the use of Gonioscope and slit lamp drainage angle examination done and grading done. If it is very shallow (occludable) the prophylactic YAG PI done.
It is a diagnostic test for the measurement of corneal thickness. It is useful in screening for the patients suspection of developing glaucoma. As pachymetry influence eye pressure readings it is important diagnostic tool. The plan of treatment can be planned with the help of pachymetry examination.Management of glaucoma
Glaucoma cases can be managed medically or surgically .After comprehensive glaucoma examination , diagnosis and opinion is finalized and according to severity of condition topical drug therapy started (single drug and dual drug or multidrug therapy).Surgical management Includes
Trabeculectomy Valvalar inplant Deep Scleroctomy Viscocanalotomy
Cyclodestractive procedures for malignanat glaucoma in blind patient.
Surgical correction of glaucoma can be combined with cataract surgery as a combined procedure.