Just like the tyre of a car is filled with air at a particular pressure , our eyes are filled with fluid at a certain pressure level. This pressure is known as Intraocular Pressure (IOP).
Normal intraocular pressure range is between 15 mmHg. to 22mmHg. Our Eyes function perfectly well when our IOP is within the normal range .
If due to any reason , the IOP of the eye increases beyond the normal range , the condition is called Glaucoma or Kala Motia or Jhaamar or Kanchia Motia etc.
If the IOP stays high for a prolonged period of time , it leads to progressive damage of the optic nerve of the eye , progressive vision loss and finally may lead to permanent blindness.
Inside our eyes, water is continuously being made to keep the eyeball filled . At the same time , an equal amount of water is being drained out continuously . The process of making and draining of the water is very cleaverly controlled so that the intraocular pressure stays within the normal limits. If due to any reason , the drainage of water from the eye gets reduced , the pressure of water inside the eye will increase , leading to glaucoma.
There are three main types of Glaucoma
1. Open Angle Glaucoma .
This is the commonest form of glaucoma and also the most dangerous. In this type of glaucoma , the IOP does not increase very high and the patient does not feel anything wrong with his eyes. There is no pain or discomfort. If the IOP stays high for a long period of time , the optic nerve of the patient continues to get damaged .If not checked or not noticed , the patient may not realize problem to his vision until a lot of damage has taken place. By that time it is too late . Whatever vision is lost due to glaucoma cannot be recovered. This type of glaucoma is very dangerous because it comes as a thief and steals the vision away without the patient getting to know.
2. Narrow Angle Glaucoma .
In contrast to the open angle glaucoma , the Narrow angle glaucoma comes like a dacoit come to rob a place. The IOP of the eye suddenly rises very high . There is extreme pain , discomfort , vomiting and blurred vision. No painkiller can reduce the pain caused due to this type of glaucoma. Because of the symptoms, the diagnosis of this type of glaucoma is made early and treatment started early.
3. Neovascular Glaucoma
In eyes with advanced diabetic eye disease or hypertensive eye disease with blockage of veins of the retina , new abnormal blood vessels start forming inside the eye which block the drainage of water from the eye, thus causing Glaucoma. This type of glaucoma is often very tough to treat.
4. Post injury Glaucoma
This type of glaucoma may result after injury to the eye eg, injury with a tennis or squash ball , badminton shuttle , fire-cracker . The injury tends to damage the water drainage channels of the eye , leading to rise in the IOP and hence glaucoma.
Glaucoma is diagnosed and monitored with the help of
1. Intraocular pressure measurement.
2. Automated Visual Field charting.
3. Contral Corneal thickness measurement
4. Retinal Nerve Fibre Layer thickness measurement.
1. Anti glaucoma medicines :
Anti glaucoma medicines are the mainstay of treatment of glacoma today. A majority of patients benefit from this . These medicines must be used througout life or as long as the eye doctor advises to.
2. Operation for Glaucoma.
In case maximum dosage of medicines fails to control the IOP , surgery must be done to bring down the pressure.
Yes , children may also suffer from glaucoma . This is known as Congenital Glaucoma . In children , born with this type of glaucoma, the size of the eye(s) becomes bigger than normal and there is continuous watering from the eyes. Also , the child is unable to keep his eyes open in bright light.
Such children should be examined by an eye surgeon as soon as possible and treatment started.
Management of Glaucoma is a lifelong committment and co-operation between the eye doctor and the patient and must be carried out as long as it is necessary.
At Dr.Daljit Singh Eye Hospital, we are doing minimally invasive glaucoma surgery with the use of a novel instrument known as the Fugo Blade.