Glaucoma – Silent Thief Of Vision
The management of glaucoma is an emergency as the vision lost can NEVER be recovered.
Types of Glaucoma
- Open angle
- Closed angle
Gonioscopy test is a must to differentiate between the types of glaucoma
These form the backbone of management of patients with glaucoma. The investigations inlucde:
- Intraocular Pressure (IOP) assessment – the cornerstone of management is IOP assessment and management to keep it within limits. For normal individuals, IOP of less than 21 mm Hg is taken to be normal. The target IOP is lowered in patient to a level depending upon the severity of the glaucoma already present.
- Pachymetry – This is done to know the cornea thickness to have the correct intra-ocular pressure measurement
- Visual Fields – Assesses the damage to the optic nerve due to glaucoma. Usually starts to get affected once 50% or more of the optic nerve is affected. Very important test to be done 6 monthly or earlier in established glaucoma patients.
- Retinal Nerve Fibre Thickness Analysis – Assesses the glaucoma stages much earlier than visual fields and is the procedure of choice for early glaucoma patients. The test is also useful to detect and diagnose glaucoma.
The main goal of treatment is to modulate the eye pressure (IOP). This can be done by either:
- Medications in the form of drops, tablets
- Trabeculectomy – routine Glaucoma surgery
- Valve – selected cases or non-responding cases