Glaucoma Frequently Asked Questions

Glaucoma is slow progressive disease that damages your optic nerve due to raised intra ocular pressure (eye pressure) over a long period of time.

Anybody above the age of 40 years can get glaucoma. Hence, a routine eye evaluation is necessary every year.

A person is more susceptible to get glaucoma if:

• His/ her family members have glaucoma
• Has high minus numbers (myopia)
• Using steroid in the form of ointment, eye drops, skin lotion, inhaler, oral tablets for long time
• Have history of trauma to the eye
• Have diabetes or hypertension

Glaucoma is mostly asymptomatic. It is picked upon routine eye check up. Hence, it is called a silent thief of sight.

A type of glaucoma (acute angle closure disease) can present with sudden onset of eye pain and vomiting. You should be suspicious if you have a frequent change in your spectacle numbers or see colored haloes around a source of light.

The doctor diagnoses glaucoma by a combination of tests:

• 1. Applanation tonometry or eye pressure measurement
• 2. Pachymetry or thickness of cornea(over which pressure is taken) is measured
• 3. Gonioscopy : check the outflow pathway of eye fluid (aqueous humor) in your eye
• 4. Dilated fundus evaluation: examine the optic nerve of your eye
• 5. Visual field test or perimetry: to examine the area of damage done by glaucoma in your field of vision.
• 6.Optical coherence tomography (OCT) : to examine the layers of optic nerve using a 3D scan in case the never looks doubtful for glaucoma.

Following investigations are important for glaucoma:

• 1. Applanation tonometry
• 2. Pachymetry
• 3. Gonioscopy
• 4. Dilated fundus evaluation and disc photos
• 5. Visual field test or perimetry
• 6. Optical coherence tomography

A perimetry or visual field test needs to be repeated yearly in cases of mild glaucoma and every 4-6 months in cases of moderate to advanced glaucoma.

OCT needs to done yearly.

Following treatment options are available for glaucoma:

• 1. Eye drops
• 2. Laser
• 3. Trabeculectomy: creating a new outflow pathway for eye fluid to reduce eye pressure. It can be combined with cataract surgery
• 4.MIGS (Micro invasive glaucoma surgery): opening the already existing outflow pathway of eye fluid to reduce eye pressure. It can be combined with cataract surgery. It helps to preserve the tissues required to perform major glaucoma surgery (trabeculectomy) for future.
• 5.Glaucoma drainage device [GDDs] (Ahmed glaucoma valve, Aurolab aqueous drainage implant): In cases of severe glaucoma not responding to medications as well as failure of trabeculectomy, these devices are implanted in the eye to drain the eye fluid to control eye pressure.

Glaucoma cannot be cured. However, its progression can be controlled by keeping the eye pressure in control using eye drops, laser, trabeculectomy or MIGS or GDDs. Lifelong follow up is necessary to keep the disease in control.