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Dr. Rupande's Eye Care


Glaucoma is disease of optic nerve where increased
intraocular pressure in the eye causes damage to
the optic nerve. It is one of the leading causes
of blindness in our country. Our eye secretes
clear fluid called aqueous humor which helps in
the supplying the necessary nutrients to the eye.
This also helps in keeping intraocular eye pressure
within normal limits. Usually the fluid produced
is balanced by the fluid draining out, but when
drainage angle is blocked, the fluid pressure in
the inner eye increases. When aqueous humor gets
clogged the damage occurs because there is
weakness in the optic nerve.







             



ANGLE - CLOSURE GLAUCOMA

Angle-closure glaucoma is caused by a sudden increase in the intraocular pressure (IOP) inside the eye, where the iris (the colored part of the eye) is pushed or pulled up against the trabecular meshwork (or drainage channels) at the angle of the anterior chamber of the eye and so the fluid (called aqueous humor) that normally flows out of the eye is blocked and cannot drain out, thereby increasing the IOP. The damage to optic nerve depends on how much pressure there was and how long it has lasted, and whether there is a poor blood supply or other weakness of the optic nerve. People who are farsighted (called hyperopia) are at an increased risk for acute angle-closure glaucoma because their anterior chambers are shallow and their angles are narrow. Sometimes, the attack may be caused by dilation of the pupils, during an eye examination, after visualizing a movie.




SYMPTONS


TREATMENT

Immediate treatment is essential to prevent optic nerve
damage and vision loss. Initial treatment is depends on
the clinical findings and will be either topical drops
supported by systemic treatment to clear the cornea of
cloudiness and lower the IOP. When the conditions are
appropriate then a Laser iridotomy/Surgical Iridotomy is
the treatment of choice for angle-closure glaucoma. In
Indian-Asian patients, Laser iridotomy may have to be
repeated and at times doesnít give desired results. If,
however the Ophthalmologist feels the condition chronic
or more extensive she may opt for other surgical
procedures available.


PRIMARY OPEN ANGLE GLAUCOMA

Popularly known as the silent killer, in primary open angle glaucoma there is damage to the optic nerve gradually caused by blockage of drainage channels-sieve like trabecular meshwork and the angles are open.

   



SYMPTONS

Some elderly people with glaucoma put their gradual failing vision down to 'just getting old' or getting cataract. They might not have had their eyes checked for many years and may needlessly lose their sight. The increased pressure in the eye can damage the optic nerve (the main nerve of sight) which leads to permanent vision loss.


PREVENTION IS BETTER THAN CURE

Regular eye examinations with an
ophthalmologist may identify people
who are at risk for acute angle-closure
glaucoma. The eye test normally includes:



People aged over 40 with a first-degree relative (mother, father, brother, or sister) with glaucoma should have checkup frequently.


TREATMENT


SECONDARY GLAUCOMA

In some patients glaucoma may develop as a 'secondary' complication to hyper mature cataract, Liberation of lens particles, some eye injuries, eye operations.


CONGENITAL GLAUCOMA ( BUPHTHALMOS )

The glaucoma is present from birth. Immediate and active treatment is must. Congenital glaucoma may be a part of some systemic disease like apertís anomaly or other caniosyntosis also.







SURGICAL TREATMENT
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