The eye is filled with a nourishing fluid. The pressure of this fluid maintains the sphericle shape of the eyeball much like a football filled with air. Glaucoma is a disease where there is an abnormal increase in pressure, enough to damage the inside of the eye.
Very often, it is silent and does not cause pain, which makes it a more dangerous killer of sight. It is a disease, which if not diagnosed and treated in time can have disastrous results. This damage is irreversible, making early detection and treatment extremely important. Instruments like perimetry, pachymetry and OCT allow us to diagnose glaucoma earlier than ever before. These instruments also help track the progress of the disease.
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How does the eye work ? |
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Our eye works like a camera. Light falling into the eye, is focused by the lens and the cornea (the transparent window in the front) on the retina (which works like a photographic film). These images are constantly transmitted to the brain via a cable called the optic nerve.
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What is intraocular pressure? |
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The eyeball is a sphere, which is kept inflated by a clear nourishing fluid. It is like a wash basin, where the tap is always turned on and the fluid constantly drains thought a drainpipe. The difference between the rate of inflow and outflow of the fluid decides the intraocular pressure (the pressure of the fluid inside the eye).
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What is glaucoma ? |
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Glaucoma develops when there is an increase in the intraocular pressure and this raised pressure can damage the delicate inner nerves of the eye by compressing them, consequently, the transmission of signal to the brain is impaired. The blind areas develop in the side vision and the central sharp vision is the last to be affected. People seldom notice the damage till it is considerable. If the entire nerve has been destroyed, blindness results. Fortunately, this rarely occurs if glaucoma is diagnosed and treated before major damage has been done.
The key to preventing damage and blindness is early diagnosis and treatment. An ophthalmologist is the doctor who is specifically trained to perform this examination and treat this condition. You should have yearly eye check up if you are over thirty-five years of age or if anyone in your family has glaucoma.
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Are there any other names for glaucoma ? |
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Glaucoma is know as jhamar or kalapani in India. |
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Is glaucoma more dangerous than cataract ? |
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The damage caused by glaucoma cannot be reversed, whereas in case of cataract it is reversible. Also, in glaucoma, you may lose your sight very gradually, often without any warning symptoms, making glaucoma more dangerous of the two.
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What are the causes and types of glaucoma ? |
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Chronic glaucoma |
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Most commonly, the drainpipe narrows with age, clogged by deposits, which build up slowly. This partial blockage causes a gradual increase of pressure within the eye. Because it develops over a period of time, it steals the vision so quietly that the patient is unaware of trouble until the nerve is badly damaged. The best way to diagnose this type of glaucoma is by periodic eye examination.
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Congenital glaucoma |
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The drain may be poorly manufactured. Here the drainage openings are abnormal from birth. The Cornea (front of the eyes) may become cloudy, the infant may be sensitive to light and the eyes may water excessively. This should lead to an immediate visit to an ophthalmologist, as the infant can not convey his or her symptoms.
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Acute glaucoma |
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A sheet of tissue called iris may suddenly drop over the drainage, close the drainpipe opening and block all outflow. Such a sudden, complete blockage of fluid flowing out of the eyes results in rapid and severe increase in the intraocular pressure causing severe pain redness, watering, rainbows around lights and blurring of vision. This is often an emergency and has to be treated urgently.
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Secondary glaucoma |
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Injuries, drugs, blood in the eye, tumours and inflammation can cause glaucoma by blocking the drainage channels.
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How do I know if I have glaucoma ? |
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If you have glaucoma you may have symptoms like headache, blurry vision, eyeache, colored haloes, or watering but glaucoma often behaves like a thief, stealing away vision quietly. The best defense against Glaucoma is regular examination of the eyes. If you are above 35 years of age, you should have your eyes checked every year with an ophthalmologist (your eye doctor). The check up should be at an earlier age if any of your blood relatives has glaucoma. The doctor will check your eye pressure and look up the eye nerve for any damage.
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Are there any tests for glaucoma ? |
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If your doctor needs more information, he may ask for specific tests to find whether there is any damage due to glaucoma, or how much damage it has caused. These tests can be repeated later on to know if your glaucoma is responding to treatment or not.
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Does glaucoma run in families? |
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Glaucoma does run in families. It is therefore important that you mention it to your doctor when you go for an eye check up. If anyone in the family has glaucoma, all blood relatives like brothers, sisters, parents and children must see an eye doctor to have their eyes examined for glaucoma.
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What is the treatment for glaucoma? Can it be cured? |
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Glaucoma can be treated either with drops, laser or surgery.
There are a large number of eye drops available for glaucoma. Drops, though effective, can only control eye pressure till their effects lasts, which means that stopping the drops or not instilling them regularly can damaged the eye nerve.
Laser is a very convenient and safe option available to treat selected cases of glaucoma. Laser can be used to prevent attacks in specific types of glaucoma. Sometimes the laser treatment is effective for a few years only; after which your doctor will review the further strategy for treatment.
Surgery involves making a permanent drainage for the excess fluid to come out of the eye. Surgery has many advantages, but like all surgery it has its own risks. Even though surgery is often a permanent cure, glaucoma should be monitored for life.
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Will the treatment change with time or if I have been operated, can I get glaucoma again ?
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Glaucoma is a progressive disease and worsens with age. Early glaucoma can often be controlled with one type of drop. As glaucoma advances with age, your doctor may decide to put you on more than one type of drop or on stronger drops. Similarly after surgery, the disease may progress and you may need to restart treatment.
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TAKE HOME MESSAGES |
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Damage to the eye nerve, caused by increase in the pressure of the eye is called glaucoma.
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You may not have symptoms if you have glaucoma. |
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You should have your eyes checked every year if you are above 35 years of age or at a younger age if anyone in your family has glaucoma.
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Treatment can only stop further damage, so the earlier it is diagnosed more vision will be saved. Regular monitoring and treatment mean more vision will be retained.
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Why are Regular Medical Eye Examinations important for everyone? |
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Eye disease can occur at any age. Many eye diseases do not cause symptoms until the eye disease has done the damage. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an ophthalmologist are very important.
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Why an ophthalmologist ? |
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Because an ophthalmologist provides total care for your eyes: medical, surgical and optical.
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