Glaucoma Screening & Management
WHAT IS GLAUCOMA?
Silent thief of Sight Also known as “Kala Motia” in Hindi or “Kach Bindu” in Marathi or “Jamer” in Gujarati. Glaucoma is often called the “silent thief of sight,” because most of its types typically cause no pain and produce no symptoms until noticeable vision loss occurs. For this reason, glaucoma often progresses undetected until the optic nerve already has been Irreversibly damaged.
WHAT ARE THE CAUSES OF GLAUCOMA?
There are many different types of glaucoma, but the most common type is called open-angle glaucoma — that’s what most people mean when they talk about Glaucoma. Most glaucoma are the result of too much pressure in your eye, which then squeezes the optic nerve. Damage to the optical nerve from glaucoma eventually leads to a degradation of your eyesight and if not treated promptly, can lead to blindness.
Luckily, when detected and treated early, this rarely results in any lasting damage to your vision. Because of this, it is very important that you regularly have your eyes checked by a qualified Cataract surgeon.
WHAT ARE THE COMMON TYPES OF GLAUCOMA?
The most common types on Glaucoma include:
- Open angle Glaucoma
- Closed / Narrow angle Glaucoma
- Congenital Glaucoma
- Low tension Glaucoma
- Secondary Glaucoma
WHAT IS THE BEST TREATMENT FOR GLAUCOMA?
Early detection is the key to protecting your vision! Many improvements in glaucoma surgery and treatment have been made in recent years, however, it is still vital that it is detected as soon as possible. At Insight vision we are committed to offering cutting-edge glaucoma detection and treatment. There are three main ways to treat glaucoma, but not all are equally effective.
LONG TERM USE OF EYE DROPS: First of all, in less severe cases eye drops can be used to effectively lower eye pressure. This option is great as it is not invasive, however, it is not a permanent solution.
LASER: The most commonly performed laser for glaucoma is the YAG peripheral iridotomy (YAG PI) in patients with narrow or closed angles. It needs to be performed usually in both the eyes to prevent an acute rise in pressure or an ‘attack’ of glaucoma. The patient may or may not need additional medicines after a YAG PI. Selective Laser trabeculoplasty using an Argon or YAG laser may be performed at select places to improve the pressure control.
SURGICAL: We like to try the less invasive options first, but often resort to the most effective treatment of all i.e., TRABECULECTOMY surgery.
We understand that the prospect of surgery on your eyes can be scary, however this is the best way to ensure a permanent fix when the less invasive procedures have failed. The surgery itself utilises modern techniques with very small incisions and minimal stitches, meaning you will be back to using your eyes to their full potential as soon as possible.
ADDITIONAL INFORMATION - GLAUCOMA SCREENING
Detecting Glaucoma
In recent years there have been advances in glaucoma detection, which means it can be treated earlier than ever. At Insight Vision we have access to some of the most advanced diagnostic tests and equipment. We intend to cover every base in their diagnostic testing, so that we can detect problems early and give you the necessary treatment. We are privileged to have access to the most modern diagnostic equipment in the market and will give you the best care possible. If you are in any doubt about your eyesight, or if you have not had a check-up in a while, you should consider making an appointment with us.
Tonometer is a device used for checking intraocular pressure or eye pressure. It may be checked using Applanation tonometry (AT) for confirming the eye pressure and iCare tonometer which doesn’t need even topical anaesthesia and can be done on kids as well.
The eye specialist will assess the optic nerve status including the color, shape, depth, and size of the optic nerve head to determine the overall health of the optic nerve. Ophthalmoscopy involves taking the 3D view of the optic nerve for better assessment.
Fundus camera VISUCAM helps document disc images and helps to diagnose further progression of disc damage.
Corneal thickness is measured using a pachymeter. Measuring the corneal thickness is important as people with low corneal thickness would be more vulnerable to glaucoma damage even at low eye pressure and need a more intensive pressure control to prevent glaucoma damage.
Perimetry is used to map the field of vision or the entire area you see right in front of your eyes without moving your eyes. This is the most important test for glaucoma as it helps your doctor to assess the extent of damage of the optic nerve due to glaucoma. Often this damage is irreversible. Patients with damage to their visual field need to be very careful with their medicines as we need to preserve whatever vision is left.
This test uses a hand-held lens used with or without a coupling fluid to look at the filtration angle or area involved in drainage of aqueous humour. The doctor puts some numbing eye drops and places the lens to look at 360 degrees of the angle. In patients with angle-closure glaucoma, the angle will be narrow or closed and in open-angle glaucoma patients, the angle will be open. Patients with narrow or closed angles may be recommended a laser (YAG PI) to open the angles.
OCT is a very sensitive and sophisticated imaging technology to assess the optic nerve status. It measures the retinal nerve fibre layer (RNFL) thickness, the optic nerve head (ONH) dimensions and the ganglion cell complex (GCC) parameters. Often it can detect glaucoma much earlier than other tests before even the visual field changes have appeared. It is important not only for screening and confirming the diagnosis but also to monitor the treatment. Your doctor will recommend this test depending on your eye condition and will then analyse the report to advise the best treatment for you.