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Normal Vision	Same scene as viewed by a person with glaucoma

Glaucoma Management

Glaucoma:

Glaucoma is a group of eye disorder in which optic nerve head is damaged, permanently damaging vision in the effected eye (s), change in visual field, often associated with increased intra ocular pressure. Untreated glaucoma leads to permanent damage to optic nerve and resultant visual field loss, which can progress of blindness. Glaucoma may associated with normal or low intraocular pressure.

Normal IOP varies 10-21mmHg. It is also known as silent thief of sight because loss of vision occurs gradually over a long period of

time and is often recognized only when disease is in advance stage. World wide it is the second leading cause of blindness after cataract. If the condition detected early, it is possible to arrest the development or slow the progression by proper management.

Screening for glaucoma should be done for:

Every individual over 35 years of age, especially with family history of glaucoma, trauma to eye, Diabetes, hypertension, Myopia, high hypermetropia, coloured halos, patient on steroid treatment, patient with history of inflammation of the eye.

Types of Glaucoma:

	Open angle glaucoma
	Secondary glaucoma
	Closed angle glaucoma
	Congenital glaucoma

Symptoms and signs of glaucoma:

Mostly glaucoma is painless

Frequent change of glass can occur

Narrowing of vision or tunnel vision

Progressive field loss, optic nerve head changes.

In acute attack it is characterized by sudden pain in eye, redness, watering, brow-ache, seeing halos around light, decreased vision, vomiting, headache, intraocular pressure more than 30 mmHg, mid dilated non-reacting pupil. It is an ocular emergency.

Diagnosis of glaucoma:

Common tests done for diagnosis of glaucoma are as follows :

	Tonometry: Intraocular pressure.
	Visual activity: Vision of the patient.
	Gonioscopy: To measure the angle of eye.
	Pachymetry: To measure corneal central thickness.
	Visual field test: To find out defect in field of vision.
	Fundus examination: To visualize optic nerve head and retina.

OCT (Optical Coherence Tomography): To assess retinal nerve fibre layer.

Management:

In majority of cases glaucoma is treated medically. In few cases laser treatment is required. Fewer still required major or minor surgery.

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