Instead of beginning this write up about the gloomy statistics on Glaucoma and how much of a problem it is, I will begin on a positive note. The good news is that times are changing and thanks to technology and better training - Glaucomatologists are better equipped than ever before in diagnosing and treating glaucoma. Innovations in the field of diagnostics such as imaging modalities and innovations in treatment which could be in the form of new eye drops, which are well-tolerated, to laser treatment to minimally invasive surgeries for glaucoma are seeing the light of the day. Finally, there could be “light at the end of the tunnel.”

In a glaucoma clinic, we face several questions that are a source of concern to most patients. In this primer I will try my best to address the most commonly encountered questions I face.

Dr. Elfride Sanjana

What Is Glaucoma?

Glaucoma is an eye disease that causes either a painful or a painless loss in vision depending on the mechanism involved, due to damage to the nerve of the eye called the optic nerve. It may or may not be associated with an increase in the intraocular pressure. 

What Is The Normal Intraocular Pressure?

The normal pressure in the eye is in the range of 11-21 mmHg. Anything above this value may increase the risk of developing glaucoma.

What Are The Symptoms Of Glaucoma?

This can be variable. Most often glaucoma produces no symptoms till the very late stages of the disease, and that would be a progressive painless decrease in vision, loss in the field of vision, the latter can lead to bumping into the objects in the room.  This is what we call the “open-angle glaucoma”

However, there is a second type called the “closed-angle glaucoma” that can present with sudden pain, redness and decreased vision in the affected eye.

 What Should I Do To Prevent Myself From Getting Glaucoma?

Unfortunately, we cannot prevent glaucoma. It has certain risk factors that predispose certain individuals to the same. At best, regular screening can help us diagnose and initiate treatment in the earlier stages itself.

 What Is The Angle Of The Eye?

The angle of the eye is a structure through which the fluid in the eye called the aqueous humor drains out. In closed angles the opening is not large enough and in open angles even though it is large the tissue offers resistance to drainage.

 What Are The Risk Factors For Glaucoma?

Family history, high spectacle power, presence of hypertension, diabetes, history of intake of steroids, sleep apnea, migraine, cardiac problems.

 Are There Any Lifestyle Modifications By Which I Can Prevent/Cure Glaucoma?  

No, there are none. Unlike diabetes and hypertension that benefit from lifestyle modifications, the only thing we can do is keep the disease in check by strictly following the doctor’s prescription which in the early stages is eye drops. 

 What Are The Ways Of Treating Glaucoma?

Again, this depends on the closed angle, open-angle type.

Open-angle glaucoma we first try to reduce the pressure with eye drops. If we achieve the “target pressure’ we advise continuation of eye drops lifelong. However, if the target pressure is not achieved, we offer treatment in the form of laser, and finally glaucoma surgery.

In the closed-angle type, we proceed with a laser right away and the decision on the need for medications, and in the later stage’s surgery.

Closed-Angle glaucoma also benefits from early cataract surgery.

Will I Be Cured Of Glaucoma After Surgery?  

No. the goal of surgery is to prevent further deterioration of vision. The vision /field of vision that is lost cannot be restored

How Often Should I Visit The Ophthalmologists If I Want To Ensure Glaucoma Is Diagnosed Early?

We usually recommend annual visits to the ophthalmologists after the age of 40. However, if you have a family history, are a young diabetic, wear high spectacle prescription (either myopia or hyperopia) more frequent visits say once every six months would be a wiser option

In order to create awareness for glaucoma the World Glaucoma Association and other affiliated societies across the world celebrate the World Glaucoma week between March 8th- 14th 2020.

I would encourage readers to visit their ophthalmologists and screen themselves for glaucoma. Go get your eyes tested for glaucoma! Save your sight! We are in the year 2020 after all, 20/20 is a normal vision too!

- Dr Elfride Sanjana Is A Senior Glaucoma Consultant With Dr. Agarwals Eye Hospital And Eye Research Center, Chennai