Applanation tonometer : |
| It is a Gold standard instrument to measure the Intra ocular pressure. |
|
|
| |
|
| Gonioscope: |
| It is used to study the angle between the cornea and iris in patients suspected or having Narrow angle Glaucoma. |
| |
|
| Perimetry : |
| It is used to measure the Visual field changes which are characteristic of Glaucoma. |
|
| |
|
|
|
| |
Computerized visual field analyzer (automated perimeter) OCT : |
| A computerized instrument used to |
|
 |
Ability to detect the earliest sign of glaucoma |
|
|
to accurately measure the angle in glaucoma |
|
|
detects the Ganglion cell loss , optic nerve damage, RNFL defect |
|
|
diagnosis glaucoma & managing progression |
|
|
|
|
|
| |
|
|
| |
|
| What is Glaucoma? In different tab |
| |
 |
| |
|
There is a circulation of clear nourishing fluid within the eyeball.
When the drainage of this fluid is defective, pressure begins to build up within the eyeball. (Usually the pressure in normal individuals remains in the range of 10-21 mm Hg.)
Glaucoma is a general term used to describe damage to the optic nerve usually caused by high pressure.
The optic nerve is like a cable. It has more than a million fibers that send messages about what we see from the eye to the brain. Glaucoma damages the optic nerve fibers (the “wires” in the cable) causing blind spots to develop in areas of vision. People seldom notice these blind areas in the side vision until considerable optic nerve damage has occurred. If the entire nerve is destroyed, blindness results.
This rarely occurs if glaucoma is diagnosed and treated before major damage has taken place.
Unfortunately if diagnosis has been delayed, permanent and irreversible optic nerve damage takes place which leads to loss of vision. |
| |
|
| Types of Glaucoma |
There are two main types of glaucoma: Primary glaucoma and Secondary glaucoma. Primary glaucoma has two subtypes: Open angle glaucoma and angle closure glaucoma. |
| |
|
| Primary Open Angle Glaucoma |
|
| |
|
|
|
| |
|
In "Open Angle" glaucoma increased resistance to outflow in the canal causes a rise in the pressure inside the eye. It is a long-standing slowly progressive disease process and can cause visual loss so quietly that the patient is unaware of the trouble till the advanced stage of the disease.
The optic nerve cannot withstand the prolonged periods of high pressure resulting in damage, i.e. loss of sight. The angles are open and the obstruction in fluid circulation is usually in the drainage channels. If not checked in time this form of glaucoma is reported to cause painless, progressive and total blindness.
When the disease process happens at normal eye pressure, it is called "normal tension glaucoma." |
| |
|
| How do I know I have Glaucoma? |
|
| Symptoms and Sign |
|
| Different types of glaucoma have different symptoms: |
|
| Open Angle Glaucoma |
|
| |
|
| Very often there are no symptoms in early stage of disease and hence this form is also known as the silent glaucoma. Patients may rarely have headaches or discomfort around the eyes. The decrease in vision starts in form of blurring of side (peripheral) vision, which usually goes unnoticed. As disease progresses, patient eventually is left with only small central "tunnel" vision. |
| |
|
Angle closure Glaucoma |
|
| Chronic angle closure glaucoma behaves very similar to open angle glaucoma and does not have any symptoms. In acute angle closure glaucoma, during an attack of acute glaucoma, patient develops sudden blurring of vision with severe pain around the eye and throbbing headache. He may see rainbow haloes around the light. Sometimes nausea and vomiting may be present. If not treated quickly and adequately, blindness may ensue. |
| |
|
| Who is at Risk of Glaucoma? |
|
| |
|
|
Family members with glaucoma |
|
|
Age more than 40 years |
|
|
People who has Diabetes |
|
|
Myopia (nearsightedness) |
|
|
Regular, long term steroid / cortisone use |
|
|
A previous history of TRAUMA |
|
|
High blood pressure |
|
|
Thyroid disorders |
|
| |
|
| How to Detect Glaucoma? |
|
| |
|
|
Measurement of intraocular pressure - TONOMETRY |
|
|
Inspect the drainage angle of your eye - GONIOSCOPY |
|
|
Optic nerve imaging – ophthalmoscopy, SD-OCT |
|
|
Evaluate peripheral vision of each eye – PERIMETRY |
|
| |
|
| What is the Glaucoma Treatment? |
|
Aim of the treatment is to prevent further damage. |
|
| Modalities of treatment Surgery: |
|
Treatment depends on the stage of the disease at presentation. Appropriate and early treatment can prevent the loss of sight in majority of patients. The aim of treatment is to allow the patient to lead an independent and fully functional lifestyle. Because glaucoma can progress without your knowledge, adjustments to your Glaucoma treatment may be necessary from time to time. |
| |
|
| Medical Treatment |
| |
|
|
Glaucoma is usually controlled with eye drops taken daily; they lower the eye pressure either by slowing the formation of aqueous fluid within the eye or by increasing the flow at the drainage area |
|
Maintain proper timing of application suggested by your doctor. |
|
Do not change or stop taking your medications without consulting your ophthalmologist. |
|
If you are about to run out of your medications, ask your ophthalmologist if you should have your prescriptions refilled. |
| |
|
| Laser treatment |
| Open-angle glaucoma the draining angle itself is enlarged to control eye pressure. Angle-closure glaucoma the laser creates a hole in the iris to open up and improve the flow of aqueous fluid to the drain. |
| |
|
| What is your part in the treatment? |
| |
|
| Treatment requires a team effort [you and the doctor]. The prescription must never be altered or stopped without consulting your doctor. Frequent eye examinations and tests are critical to monitor your eyes for any change. |