| What is Glaucoma (Kala Motia)
Glaucoma is a condition where the fluid pressure inside the eye rises to such a level that it damages the delicate structures of the eye. specially the nerve of sight (Optic Nerve). This condition is very different from Cataract (Safed Motia) in which the natural lens of the eye becomes opaque and has to be removed. Glaucoma is more dreaded than cataract because the loss of vision due to it can not be reversed as opposed to the vision loss in cataract which is easily restored by surgery.
Types of Glaucomas and their Symptoms:
- 0pen Angle Glaucoma: It causes a painless gradual diminution of vision.
The patient does not even realise the problem till the disease is quite advanced.
- Narrow Angle / Angle Closure Glaucoma: The more common notion that 'Kala Motia' is accompanied by pain can be seen in this condition. It is often accompanied by symptoms of seeing colored halos (rainbow rings) around 1ight.
- Secondary Glaucomas: can be due to many reasons some of which are i.) Prolonged use of steroids (prednisolone / cortisone) as eye drops or at times as tablets or skin creams .. ii .)Over ripe Cataract (Safed Motia) in which surgery has not been done in time. iii.) Injury or bleeding inside the eye.
- Congenital Glaucomas Due to various types of birth defects.
Diagnosis of Glaucoma
All glaucoma however have three features in common and these are used to diagnose Glaucoma and to measure the damage caused by it :
- Increased Intra-Ocular Pressure (I.O.P. or Tension) : measured by various types of tonometers 1ike Schiotz (meta11ic scale type). Goldmann Applanation or the Computerized Non-Contact Applanation types which measure pressure with a gentle puff of air without actually touching the eye.
- Cupping or Atrophy of the Optic Nerve: The drying up of the nerve of sight it suffers damage due to high pressure inside the eye. Seen on Fundus Test of the eyes.
- Visual Field Defects: The patient gets missing areas in the field of sight ,though, he/she may be seeing well otherwise. This is measured on instruments ca1led perimeters. The modern perimeters are computerized to measure and to a great extent self analyze the defects.
- Spectral OCT. RNFL Analysis : To document structural changes in the.
retinal nerve fibres & optic disc. Anterior segment OCT for angle tests.
- Diurnal Variation tests. Corneal Pachymetry & Hysteresis.
Suqqested GlaucQrnq screeninq schedule in Hiqh Risk groups
- People with high intraocular pressure (I.O.P.): Regular visit to the eye specialist with Tonometry, Fundus and Visual Field testing.
- People over the age of 40 years with no previous glaucoma at least once every 2 years. especially whenever there is a change of reading glasses.
- Family history of Glaucoma: regular screening from younger age for people with parents or close blood relatives suffering from glaucoma.
- People having high minus numbers or those having plus numbered glasses for distance also.
- Other high risk factors like Diabetes, Injury to eye, following any major eye surgery , prolonged steroid use etc .. need more frequent screening as advised by the treating physician.
Treatment of Glaucoma
There are three modalities of treatment: Medicines. Laser or Surgery.
The best treatment in any individual case is to be decided by the treating eye specialist. Since most of the damage due to glaucoma is not reversible, timely and regular treatment is very important. Early detection is the key to preventing progressive loss of sight from glaucoma. A target I.O.P. for a particular patient is determined as per the consultant's assessment.
How to interpret your Glaucoma screeninq result (Intra-Ocular Pressure)
I.O.P. below 19 mmHg = Less likelihood of Glaucoma
I.O.P. of 19 to 21 mmHg = Borderline
I.O.P. above 22 mmHg = High risk of Glaucoma
This information is for general guidance only, please ask your eye specialist about specific advice in your case.
Issued in the interest of Public education & Eye care by :
GROVER EYE & E.N.T. HOSPITAL. Estd. 1962. (Advanced Surgery & Laser Centre) Equipped with the Region's only Computerised Non-Contact Tonometer and Humphrey Visual Field Analyzer (Computerised Perimeter). YAG Laser, SLT.
140, Sector 35-A. CHANDIGARH, Phones :2660040. 2603323, 2660519, 2601203
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