Note on Glaucoma

Well, I am hearing about this pandemic chronic disease for some time now, and thought I could post an article on it, however limited by my knowledge and expertise in this field.

Glaucoma is a condition and not a disease. The disease which causes it is unknown. The hero of the story is the aqueous humour secreted by the cilliary gland. The purpose of this humour is to reduce friction of the eyes, and to supply oxygen and nutrients to different eye parts.

After doing the door delivery to different parts, the aqueous humour drains through a meshwork arrangement from the eye. The humour it plays with glaucoma patients is that, it fails to drain at the rate it is produced. From another perspective, it is produced more than it can be drained.

The subsequent effect is the increase in the IntraOcular Pressure(IOP), due to the stagnant fluid. This pressure ruptures the optic nerve and damages it. Slowly and unknowingly the patient loses valuable eyesight, from the periphery. Since the early loss is from the periphery, it is not often detected until it reaches near the center of vision. More unfortunate is that this disease has no symptoms or pain.

Good news is that doctors can detect it easily from the pattern of optic nerve and often prescribe a field test as a first step. The field test is an easy and simple test wherein the patient has to stare at a cross sign in the center of a screen, while dark and dim lights periodically glitter at all points. This is done one eye at a time, and to check until which point in a person's periphery, he can actually detect the spot. This tells the extend of the periphery vision damage.

The second test may be the optic nerve photo session, where glamourous photos of the optic nerves are taken. This is usually followed by some tests, if the doctor is still not convinced that the person is a glaucoma patient or not.

Usually the tests cost between Rs. 500 to Rs. 2000, not bad at all considering the damage this condition causes.

If the person is a Glaucoma patient then he must be put into immediate medication and/or surgery depending on the severity. Usually two types of medication are available:
One to reduce the production of aqueous humour and two to improve the drainage systems in the eyes to accomodate better aqueous flow.

Usually drops are given with surgeries reserved for later stages. Advanced surgery measures are available now, but that doesn't warrent not using drops after that.
Glaucoma being a chronic disease, the person has to take the drops/medicines life long(although life is short, doctors prefer the term lifelong); and check his/her IOP condition regularly. This is because to check the activities of the medication.
If the pressure increases inspite of the medication a different medicine is prescribed or surgery is done.

If untreated the Glaucomic condition may lead to blindness as a very final stage. Before that people gradually lose vision. The current advancement in Glaucomic care, can prevent further optic nerve and vision damage, from the stage it was detected. However, Glaucoma is not a reversible process, till now, but doctors are hopeful it will be soon.

Some factors about Glaucoma:
1. Rated second largest cause of blindness by WHO.
2. Glaucoma is hereditory. Do check if you have it if your family members are affected. usually it is enough to check every 3-5 years below 50 years and every 2 years above 50 years.
3. Glaucoma affects any age. There are also children born with Glaucoma, called congenital glaucoma.
4. It affects mostly Afro-Americans and Asians more than other races in comparision.
5. The normal eye pressure should be between 10-20 mm Hg. If anything above that, it might lead to IOP resulting in Glaucoma.
6. There is also a Normal Pressure Glaucoma, hence pressure is not the determining factor.
7. It is not known as to what causes Glaucoma, but its conditions and treatment are advanced.

There is nothing to worry about Glaucoma. A Glaucoma patient is like every other normal person, can do everything, but he/she has to stick to his/her medication and visits the doctor regularly.

I wish you all a very happy and healthy life.

the end.