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Your complete guide to Glaucoma.

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Have you recently been diagnosed with Glaucoma? Here’s what you need to know.

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Optic nerve showing glaucomatous changes.
  • 1.     The optic nerve at the back of your eye is responsible for your vision. In cases where the eye pressure increases, it can affect and damage your optic nerve and cause blurring of your peripheral(side) vision.

  • 2.     If you have advanced glaucoma, your peripheral vision is likely affected. You are advised to turn your head and look on both sides before crossing a road to ensure you don’t miss any oncoming traffic, as well as turn your head down while climbing down stairs to prevent falls.

  • 3.     Remember that are once you are diagnosed and started on treatment, you will never go completely blind due to glaucoma. To preserve your vision you must maintain regular follow ups with your ophthalmologist for regular check-ups.

  • 4.     In very advanced glaucoma, driving would be unsafe. But in very early glaucoma, especially those where in the upper field  alone is affected ,you may continue to drive  safely after consulting your treating ophthalmologist. Your treating eye doctor will advise you ,if and when to stop driving, based on the extent of the nerve involvement and visual field damage.

  • 5.     Please discuss with your ophthalmologist as to what are your sleeping and waking hours so that they can guide you as to the correct time to put the drops for your particular lifestyle .This is with a view to maximize the effect of drug therapy. There are some eye drops however that are known to causes itching , burning or redness of the eye. Sometimes, eye irritation can occur months or years after being on the very same medicine. Please ensure that should you develop any of these at any point in time, you must go and discuss these symptoms with your treating ophthalmologist.

  • 6.     The drops will have to be put daily, most likely lifelong. Be rest assured that there are no other side effects that could harm either the eye or any part of the body by these long term drops ie. they are safe. These drops work on a day to day basis, the day you miss your drops your eye pressure is not controlled. You are advised to use your drops diligently, as irregularity could cause further damage and progression of glaucoma.

  • 7.     You must know that glaucoma oftentimes runs in families. You are urged to get your siblings and children’s eyes checked by your ophthalmologist.

Here’s a video describing the correct technique of instilling eye drops. (Hindi)

Here’s a video describing the correct technique of instilling eye drops. (English)

Recently diagnosed with glaucoma? Wondering if you really have it? Look here..

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Glaucoma occurs when increased eye pressure causes changes and damage to the optic nerve
  • Consult a glaucoma specialist and follow the given advise. You may be having one of two presentations.

  • 1-If only the nerve at the back of looks suspicious of damage from glaucoma, you may be asked to discontinue the drops and follow up regularly. Your physician is likely to get OCT scans of the optic nerve known as ‘Retinal Nerve Fibre Layer(RNFL) OCT’ at regular intervals. This test aids the clinician to pick up early changes of glaucoma, even 3-4 years before that picked up by the visual field test.

  • If either of your parents had glaucoma, you may be at a higher risk of developing it.

  • 2- You may have significantly raised pressure with no damage to the optic nerve head, (proven by normal visual fields and normal OCT RNFL) you most likely have ocular hypertension which most likely will not require treatment, unless your pressures are very high. 

What would I experience if I have glaucoma? What would the treatment include?

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Visual field changes in various stages of Glaucoma

There are two types of glaucoma broadly: 

1. Narrow angle glaucoma 2. Open angle glaucoma

In narrow angle glaucoma, you may suffer from occasional episodes of headache and you may see haloes around light. These symptoms usually resolve during sleep.

Your ophthalmologist will want to create a hole in your iris with a laser to facilitate the flow of your eye fluid to control your eye pressure.

 

If you have open angle glaucoma, you may be asymptomatic. You may need to change your glasses frequently. If you have high myopia or someone in your family has glaucoma you must get your eyes routinely checked.

 

You will be prescribed some eye drops to reduce your eye pressure. Whether you need one or two drops will be decided by your ophthalmologist. You may be given a trial in one eye to check if your eye pressure responds to the medication. The doctor will then eventually start treatment in both your eyes. 

Make sure you use extreme levels of hygiene while instilling the drops. Make sure the drop goes into the eye. Ensure that you do not discontinue the drops if they are over. Always have an extra bottle on hand. Remember, the drops are to be used long term. Please inquire about the possible side effects of the drops and should you have them revert to your ophthalmologist. Regular follow ups as advised by the ophthalmologist. Please get your OCT and perimetry tests as advised by your doctor diligently because that helps your doctor decide how good the pressure control with your drops is.

Please follow the link to understand the correct technique of putting the eye drops.

Choosing the ideal Intraocular Lens when planning cataract surgery.

My father has glaucoma and I am a bit concerned that I have glaucoma. How do I know whether or not I do?

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Timely and correct instillation of your AntiGlaucoma Eye Drops is crucial
  • If you are concerned that you have glaucoma, go to your treating eye doctor for glaucoma screening. In this, the doctor will check your eye pressure and the optic nerve at the back of the eye. Should there be any concern your doctor may choose to run a few more tests to establish whether or not you have glaucoma. Please follow your doctor’s advice.

  • These lenses despite not being multifocal IOLs provide good distance, intermediate vision and fairly improved near vision.

  • They do not have rings and therefore do not produce any visual symptoms such as glare and haloes around light therefore can safely be used for night drivers.

  • They could be considered the better choice for some retinal condition.

Are you a young 40 year old recently diagnosed with glaucoma? Here’s what you MUST know!

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Frequent eye checks as advised by your ophthalmologist is ideal to prevent progression. 

1. Why is this happening to me?
A. It could happen to anyone above the age of 40
If you have diabetes, high myopia or positive family history, you are more prone to glaucoma.

2. How long do I have with this good vision (in case of early detection)
A. You have a lifetime with good vision since your condition has been diagnosed early with a drop or two. 

3. How is my lifestyle going to be hampered due to glaucoma?
A. Not much, apart from the responsibility of instilling a drop or two in time there isn’t much that this condition will disturb you in your day to day life 

4. Is there a surgery that can completely cure this?
A. There is surgery available to control the condition if good control of eye pressure isn’t achieved with medication/drops.
But no there is no surgery to completely cure glaucoma.

5. How many times do I have to follow up? 

A. At your stage atleast 3 times a year 

6. What is the possibility passing the condition forward to my children, I have a 3 year old son? 

A. There is a chance, it's one of the reason for developing Glaucoma as your physical attributes and eye structure may be similar, although it's not a rule. 

7. What are the side effects of using medications for such a long period, maybe another 20-30 years?
A. We will find the most suitable treatment witn the least side effect for you.. But incase of mild discomfort like your eyes stay red or mild watering, we will weigh the benefits over these. As saving your vision is more important 

8. Can I drive?
A. Since your field of vision isn't much damaged it shouldn't be a problem. However, you must consult your treating eye doctor before taking this decision.

9. Can I continue to use my phone /laptop for long hours for work reasons
A. YES! glaucoma isn't going to hamper your work.
Make sure you maintain ambient light almost equal to the brightness of your devices to avoid much strain to your eyes. 

10. What exercise or food can prevent progression? A. You can continue most exercises
And try and stick to a nutritious meal nothing extra (for high myopes - avoid sudden lifting heavy weights) 

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Picture showing a transparent tube in the eye after placement of an antiglaucoma valve device.
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