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GLAUCOMA SURGERY

What is Glaucoma?
Glaucoma is an eye condition that develops when too much fluid pressure builds up in the eye. The internal or intraocular pressure (IOP), if high, can damage the optic nerve, which transmits images from the retina to the brain. Glaucoma was discovered in the 17th century, but its importance as a cause of blindness has been known only since the 19th century. Initially, in the Hippocratic Aphorisms, the word glaucoma was used to describe blindness.


How does it happen?
A fluid called aqueous humor (this fluid nourishes the cornea and the lens and gives the eye its shape) is produced in the eye, which is constantly drained out through a mesh like channel. This maintains a constant intraocular pressure around 10mm to 20mm Hg. When there is an obstruction to this circulation, fluid accumulates in the eye and pressure in the eye increases. Abnormally high levels of IOP can damage delicate visual structures like optic nerve head which can lead to gradual loss of visual field and finally to blindness, if untreated.

Glaucoma has been nicknamed the "Sneak thief of sight" because the loss of visual field normally occurs gradually over a period of time and is often only recognized when the disease is quite advanced. Once lost, this damaged visual field can never be recovered. Glaucoma is the leading cause of irreversible blindness in the world, where 60.5 million people had glaucoma in 2010. In India Glaucoma is the third leading cause of blindness, accounting for 13 percent of the country's blindness.
Glaucoma cannot be prevented but if it is diagnosed and treated early, the disease can be controlled. Less common causes of glaucoma include:
 
Types of Glaucoma

Glaucoma cannot be prevented but if it is diagnosed and treated early, the disease can be controlled. Less common causes of glaucoma include:

•    Congenital Glaucoma (Glaucoma affecting children between the ages of birth and 3 years)
•    Blunt or Chemical Injury
•    Corticosteroid Intake: Steroid-induced glaucoma results from the use of steroids
•    Blockage of Blood Vessels in the Eye
•    Inflammatory Condition and occasionally post-surgery
•    Normal Vision
•    Early Glaucoma
•    Advanced Glaucoma
•    Extreme Glaucoma


Note: if diagnosed early, it can be controlled to a large extent with medication/laser/surgery. Successfully lowering the eye pressure can prevent further visual loss from glaucoma. However, if not detected early or with irregular treatment, the patient can even become blind. Thus, it is imperative for the patient to understand the importance of this disease and also the value of regular follow-ups and compliance with medication.

Can Glaucoma be prevented?

Glaucoma cannot be prevented but if it is diagnosed and treated early, the disease can be controlled. Less common causes of glaucoma include:

  • Congenital Glaucoma (Glaucoma affects children between the ages of birth and 3 years)
  • Blunt or Chemical Injury
  • Corticosteroid Intake: Steroid-induced glaucoma results from the use of steroids
  • Blockage of Blood Vessels in the Eye
  • Inflammatory Condition and occasionally post-surgery
  • Population at risk
  • Everyone is at risk of having glaucoma from newborns (1 in 10,000 babies born have glaucoma), infants, children, youngsters to elderly. The following are the population more at risk of obtaining glaucoma:-
  • People with a family history of glaucoma
  • People having diabetes mellitus (especially, diabetes during pregnancy) /hypertension (high blood pressure)
  • People with high myopia (near sight) or high hypermetropia (farsightedness)
  • Those who take corticosteroid (anti-inflammatory) medications

Symptoms of Glaucoma

  • Frequent change of glasses
  • Painless progressive diminution of vision
  • Haloes around light
  • Narrowing of field of vision
  • Sudden onset of pain, redness of associated with headache and vomiting (Angle closure glaucoma)

Treatment

  • Medical Treatment - Eye Drops
  • Laser Therapy
  • Surgery in advanced cases or in those uncontrolled by medicine / laser
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