GLAUCOMA

 GLAUCOMA

Glaucoma is a disorderly state of the eye. It is said to be the Second major cause of vision loss in humans [and ranked next to cataract in impeding vision and finally to permanent blindness]. Like blood sugar and marginal rise in blood pressure, Glaucoma stays unnoticed with the affected person. Gradually, the Eye pressure [Intra ocular pressure NORMAL = 10-20 mm Hg, variable between persons] of the victim keeps increasing. While ‘Cataract’ is characterized by gradual blocking of vision, Glaucoma does not cause symptoms detectable by the patient / victim. So, the onset and establishment of Glaucoma are not ‘items of suspicion’ even for the patient. Often, it is during ophthalmic [eye] investigation for general vision, that Glaucoma is detected by the eye doctor [Ophthalmologist]. Till such time of investigation, Glaucoma escapes notice and remains a ‘polite offender’.

ISSUES TO UNDERSTAND

Unlike most other sensory organs, Eye looks a ‘glass ball –like’ body. The glossy look is due to ‘fluid-filled state’ within the eye. Such an organization is behind the ‘life’ in the eye ball. The shape of the eye ball is maintained by the secretion and accumulation of the ‘internal fluid’. However, the volume of secreted liquid cannot exceed a limit; if it exceeds, pressure within the eye ball will also increase. Increasing pressure within the eye exerts pressure which constantly presses the tissue at the rear of the eye and in turn exerts pressure on optic nerves. When under constant pressure, optic nerves lose the ability to transmit signal to the brain. With no signal transmission, the eye loses vision and becomes blind permanently. So, Glaucoma –unattended to can lead to permanent blindness

THE DISORDER

As explained earlier, the fluid within the eye is an automatic secretion by internal glands. However, to keep the apt fluid level, an inward canal also occurs near the edge of the eye. For some persons, the inward inlet gets clogged by minute microscopic deposits; it is a disorder. Surgical corrections are not recommended largely because the physiological disorder may repeat itself rendering the intervention ineffective. It is only the inward drain line which is clogged while the fluid delivery into the eye remains normal. So, more and more fluid gathers within the eyeball causing increase of Intra-ocular pressure / IOP or eye pressure. Uncontrolled pressure in the eye can lead to permanent loss of vision. Since the disorder is physiological in nature, chances are both eyes suffer IOP.

TREATMENT

Generally ‘GLAUCOMA’ cannot be totally cured. But remedial measures are available. All these processes do not interfere with the fluid secretion; but they help to expel ‘extra liquid’ in trickles on a daily administering of Eye drops –designed to lower the eye pressure. However, to get rid of the excess fluid from the eye, laser therapy is given making fine dots of puncture to remove the fluid. But, these may not help for long term. So, patients are advised to use special Eye drops as a daily routine. Depending on the extent of requirement, each eye may be treated with 1 drop once or twice daily, until further review. Normally review of Glaucoma is once in 6 months. After review, the drug and dosage may be revised upward or downward. Being a matter of concern for vision, patients must present themselves for review.

MORE RECENTLY

Glaucoma has been identified to be a genetically influenced condition [Hereditary].  Hospitals have big display facility suggesting that ‘Glaucoma’ patients “advise your siblings / parents to have their eyes tested for Glaucoma”. It cannot be permanently cured though it can permanently rob us of our vision if not attended to.

Prof. K. Raman