Jan Jyoti

E-Mail: jjssehjbp@gmail.com

GLAUCOMA FAQ'S

Q1. What is glaucoma?

Glaucoma is a cumulative ocular disease that leads to permanent vision loss by causing damage to the optic nerve which connects the brain and the eye. Glaucoma refers to the group of eye conditions that damages the optic nerve. The optic nerve is an important part of the body as it helps in transporting information from our eyes to the brain. High pressure of the eye often damages the optic nerve and affect vision after all glaucoma can even happen with normal eye pressure as well. It is more common in adults but it can happen at any age. it is one of the most common reasons for blindness for people above 60. Glaucoma affects are very gradual and it might take years to evaluate and understand the symptoms as it comes with no warning signs. If you are already facing eye issues you should often have eye check ups to avoid complications and vision loss if glaucoma perceived at an early age can be prevented and treated properly. With glaucoma, you will need treatment for the rest of your life. you need to see the doctor and seek their recommendation if you experience any early symptoms as early treatment can help prevent future complications related to the eye.  2.7 million people over the age of 40 are diagnosed with glaucoma which will get doubled by 2050 based on estimation.  A complete dilated exam is the only way to ensure glaucoma and it is better not to wait for the systems to arrive as it is a gradual process and takes time to show up. Go for regular eye check-up if you  already have problems related  to vision

 

Q2. How common is glaucoma and why is known as the silent thief of sight?

According to estimation it is stated that Glaucoma affects more than 70 million people worldwide. 12.3 per cent of global blindness is accounted by glaucoma which leads to irreversible blindness. People belonging to the age group of 70 and above are 5 per cent affected which further increases to 9 per cent for the people belonging to the age of 80. Glaucoma is often called the silent thief of sight because this leads to permanent vision loss which cannot be revered in any near future. Glaucoma has  no symptoms in its early stage and by the time symptoms occur occasionally it will make the vision worst and a large amount of vision will be lost. so if you already have glasses or you use contact lenses you should go for the monthly check-up as recommended by your doctor to catch glaucoma at the early stages. If doctors address slight changes in your vision which can develop progressively and impact your vision doctors will immediately recommend you give a test for successive evaluation and treatment. once you know that you have been diagnosed with glaucoma you should  take  regular follow up and start your treatment as soon as possible.You should not ignore thinking about the fact that glaucoma affects only people belonging to the age above 40 or 60  as it can affect anyone belonging to every age group. In simple words, glaucoma slowly damages the eyes and leads to the vision loss  which is irreversible and irreparable.

 

Q3. What are the symptoms of glaucoma

Symptoms of glaucoma completely depend on its level or stage as there are no early symptoms for glaucoma. Glaucoma has different types and stages such as open-angle glaucoma, glaucoma in children, acute-angle glaucoma, normal tension glaucoma and pigmentary glaucoma. Open-angle glaucoma where there are no symptoms in the early stages will gradually experience patchy blind spots in the side vision which is also known as peripheral vision. In this type of condition, you will face difficulty in the later stages with your central vision. In acute angle closure glaucoma you will experience severe headaches, eye pain, blurred vision, vomiting and nausea, coloured rings around the lights and eyes redness. in normal tension glaucoma you will observe no symptoms in the eraly stages but gradually experience blurred vision and side vision loss in the late stages. Glaucoma in children can be observed as cloudy or dull eye, increased blinking, and excessive tears without crying, blurred vision, headaches and near sight. Pigmentary glaucoma can cause halos around lights, gradual vision loss and blurred vision with exercise. If you or your children observe or experience as the discussed symptoms  at an early or later stage then you should immediately seek medical help from your doctor as glaucoma  can be prevented when recognized at an early stage.

 

Q4. When should glaucoma screening test starts

Though it is important for people belonging to every age group to maintain eye exams.as the eye examination is very essential for evaluating the problems an complications of the treatment. Glaucoma screen test completely depends on the risk factors and they can also vary from the age of people. if a person has a family history of glaucoma the recommended screening starts at the age of 20. However irrespective of the risk factors you are recommended to start screening from age of 40. It is rare that glaucoma happens at an early age but the majority of people get diagnosed with this condition around the age of 40. And it is also highly recommended to people above 60 have a screen test.  after 40 years you will be recommended to have a screen test every year or two as after the age of 40 people experiences hypertension ( high blood pressure), near-sightedness or any underlying disease which entertain conditions like glaucoma to progressively affect vision. Screening testing comprises ophthalmoscopy which is a dilated exam that distinguishes the colour and shape of the optic nerve when the optic nerve is damaged this test is performed and examined.  Tonometry measures are also considered while evaluating the screening test that measures intraocular pressure. tonometry is a device which is briefly placed against the eye after the numbing drops. the final test is pachymetry which helps in perceiving intraocular pressure this test is quick and completely painless and done when the problem is examined based on the other previous test. The field of the vision is mapped with the help of a perimetry visual test that observes the side vision and another test called gonioscopy is also performed with the numbing drops  and evaluates the angle between the cornea and iris

 

Q5. How often should I see my doctor once diagnosed

For effective glaucoma, treatment is essential to take regular follow-ups as it can lead to vision if not treated on time. All adults belonging to the age of 40  are recommended to check for glaucoma every 3 to 5 years. People with a family history of this condition should get a complete eye exam every 1 to year because glaucoma gradually progresses and has no symptoms in early stages. Once you are diagnosed based on your age and condition some doctors can prescribe you to have a regular check-up once every three to six months and during these follow ups doctors will evaluate intraocular pressure as this changes over time, can your optic nerve check the signs for damage along with which you will be asses with peripheral visual field to monitor the loss associated with the visual functions. Glaucoma is a cumulative lifelong disease. Therefore it is important to take follow-up appointments to observe the damages that occurred as peripheral or side vision can happen anytime. Follow helps to monitor the changes to manage the treatment. A follow-up appointment can differ  in each case as it varies from  person to person based on the factors like age and seriousness Appointment  is prescribed based on the individual case.  

 

Q6. What are the risk factors

Genetics and family history, race, myopia, refractive error, hypertension, hypertension, vasospasm, migraine, pigmentary dispersion syndrome, pseudoexfoliation syndrome, obstructive sleep apnea syndrome, diabetes, medication-related IOP, smoking and fluctuation in IOP are some of the risk factors involved with glaucoma as it carries a bundle of visual and non-visual symptoms and is considerable symptoms for the patient  with most advanced cases of this condition. There are no symptoms or very moderate symptoms  in the eralys atge of myopia. Sensitivity is very high in the early stage of glaucoma and the above-scaled symptoms offer a reliable estimate which is associated with the glaucoma treatment. Some m symptoms might occur due to the treatment of glaucoma. Age is the greatest risk factor for primary open-angle glaucoma. open-angle glaucoma refers to the group of glaucoma where the drainage angle of the eye is wide open, eye pressure or intraocular pressure is the second major risk factor associated with glaucoma and all the current glaucoma treatments considered eye pressure through surgery, laser or medications. Corneal thickness is also determined as a risk factor. the cornea is the clear window which measures the eye and people with thinner glaucoma are more likely to get diagnosed with glaucoma. Relationship between diabetes, blood pressure and glaucoma is not established but controlled blood sugar  level helps initiating the  healthy lifestyle which can prevent conditions like glaucoma  and cataract in adulthood.

 

Q7. How does lifestyle affect glaucoma

The first line of therapy for treating glaucoma is medication and trabeculoplasty. surgical approaches are only considered when glaucoma symptoms continue to progress and are not controlled with medications and other techniques. People are aware of lifestyle disorders that not only hamper the eyes but overall health. a non-pharmacological approach such as lifestyle modification can also be beneficial in managing glaucoma. It is the responsibility of the doctor to communicate patients’ concerns related o lifestyle which can benefit the treatment of glaucoma and other underlying condition as well.  Lifestyle  brings additional improvement in compliance with the therapy.   According to the study, you should consume green leafy vegetables which can lower the risk of glaucoma. Once the dark leafy vegetables are ingested nitrates present in them are converted into nitric oxide which acts as a protective agent against glaucoma. Omega-3 fatty acids tend to improve ocular health but it is still controversial when associated with glaucoma however in some of the studies it has been found that consuming large amounts of omega-3 fatty acids tends to give rise to a condition like glaucoma.  Diets which highly include fruits can lower the risk of developing glaucoma as fruits have antioxidants. Some physical activities can also be done in order to control the development of glaucoma such as aerobic exercise can cause decrement in IOP as participating in physical activities increase heart rate. Yoga has a major influence over the lifestyle of the people but unfortunately, yoga cannot be exercise to prevent glaucoma as it can be harmful l thus exercise done in moderation can be beneficial in management of glaucoma

 

Q8. How can I prevent glaucoma

Once diagnosed with glaucoma you cannot prevent it until is recognized at the early stage because once symptoms get severe it becomes impossible to reverse its impact. If you have any family history you should go for a check-up and evaluate the issues but if you don’t have a family history as well as symptoms you can evaluate his after the age of 40. once you are diagnosed with glaucoma tour health care provider will review your medical history and conduct an eye examination where your intraocular pressure will be measured which is known as tonometry, optic nerve testing will be examined, areas of vision loss will be evaluated along with the corneal thickness testing. As it can be reversed but can be managed with treatments and medications which will slow down the developing process of glaucoma. this treatment usually starts with the recommendation of eye drops prescribed by your doctor. Eye drops prescribed by the doctor are Prostaglandins, Beta-blockers, Alpha-adrenergic agonists, Rho kinase inhibitors, Carbonic anhydrase inhibitors and Miotic or cholinergic agents. You can experience some discomfort and after-effects after eye drops as eye drop medicine is absorbed into your bloodstream and always remember to wait at least five minutes between using different drops. Surgery and other therapies can also be used to prevent glaucoma’s such as laser therapy, filtering surgery, drainage tubes and minimally invasive glaucoma surgery (MIGS). After the procedure, you will be asked to see your doctor to address the progress after the surgery because if any complications occur you might need to go through additional surgery.

 

Q9. Is there any method to detect glaucoma

It is usually detected during the usual routine test as this condition doesn’t come up with the rare stage symptoms. Symptoms are often noticeable after years. if your doctors examine that you are diagnosed with glaucoma you will need to go through some tests for monitoring other conditions.  If you elderly diagnosed with a vision problem you should regularly visit your doctor for routine checks once in a while for monitoring the progressive changes if glaucoma is recognized it should be treated as early as possible. There is a number of tests which you will recommend but there is not any specific method to detect the presence of glaucoma in your eyes.  Tonometry for eye pressure measurement, ophthalmoscopy for optic nerve damage, pachymetry for cornea thickness, perimetry for peripheral side vision and gonioscopy for eyes drainage angle are some of the tests used for examining the condition like glaucoma in a patient irrespective of age but respective of the condition an issue addressed during the routine check-up.  If doctors address slight changes in your vision which can develop progressively and impact your vision doctors will immediately recommend you give a test for successive evaluation and treatment. once you know that you have been diagnosed with glaucoma you should  take  regular follow up and start your treatment as soon as possible.

 

Q10. Does glaucoma affect daily life

People diagnosed with bilateral glaucoma reports that they find it difficult tp board arrays of tasks such as walking, reading and driving. driving cessation and limitation, slower walking, falls and bumping into objects are some of the reasons associated with bilateral glaucoma. However, studies suggest that measurable effects demonstrated the difficulty caused while reading.  Above discussed reasons associated with the bilateral visual field address the increments in the symptoms of glaucoma which, measurably impacts the mobility and driving ability of an individual. While living a life with glaucoma comes with many adjustments so you should not limit yourself. You can live your life actively with the proper treatment and medications. Once all the tests are done you can l, live normally while some of the adjustments will be done but you can make your life fulfilling with adherence to medications and routine follow-up.  There is no discomfort associated with glaucoma as it is completely painless. There are gradual changes in the vision due to glaucoma so there won’t be any progressive changes. it is rare to see the severe effect of glaucoma on the other eyes as well because it is associated with ageing but can affect anyone at any age however it is preferably seen due to ageing.  Glaucoma don’t affect your daily life dangerously but there are some precaution which needs to be considered by the patients such as strict adherence to medication, a healthy lifestyle and routine follow up.

 

Q11. What causes high eye pressure

There are five main causes associated with high eye pressure which lead to ocular hypertension diagnosis. Too much aqueous production in the body can increase the high eye pressure and sometimes slow aqueous drainage also cause high eye pressure because of this drainage systems functions slowly and also drains slowly so the body should be able to produce the right amount of the fluid in orde to function properly otherwise it can lead to ocular hypertension. Some injuries give trauma to the eye which is also associated with the aqueous as injuries can disrupt the functioning of the aqueous. injuries can leave an impact for months and years after the injury.  Some types of medications such as steroid medications and steroid eye drops can also lead to high eye pressure. Corneal arcus, pigment dispersion syndrome and pseudoexfoliation syndrome are some of the other eye conditions associated with high eye pressure. This condition does not have any side effects. due to annual tests, it can be detected with the help of an instrument called a tonometer for measuring IOP.  Doctors will perform some tests and evaluate the damage to the optic nerve. The presence of high eye pressure can increase the risk of developing glaucoma as this suspect the damage the optic nerve which ultimately leads to vision loss in future. symptoms like severe and throbbing eye pain, headache, blurry vision, nausea and vomiting, eye redness, or seeing halos can enterprise glaucoma so be active to immediately seek medical help if you experience any of these symptoms.

 

Q12. Is there only one type of glaucoma

No there are four types of glaucoma such as chronic glaucoma which is also known as open-angle glaucoma, acute glaucoma also known as angle closure glaucoma, secondary glaucoma and normal tension glaucoma. There is no discomfort associated with glaucoma as it is completely painless. There are gradual changes in the vision due to glaucoma so there won’t be any progressive changes. it is rare to see severe effects of glaucoma on the other eyes as well because it is associated with ageing but can affect anyone at any age IOP leads to open-angle glaucoma which is the most common form that builds typically overtime and affects people above the age of 40. Acute glaucoma is a rare condition as it requires immediate treatment and attention and it impacts 1 in 1000 people with symptoms of blurred vision, eye pain, headaches, vomiting and nausea. underlying medical conditions such as hypertension, diabetes and ocular conditions cause trauma to the eye named secondary glaucoma which accounts for 10 percent of all glaucoma cases whereas normal tension glaucoma occurs when the optic nerve is damaged even without any existence of high IOP and its cause is still unknown  and is impact accounts 30-40 per cent of people.

 

Q13. How is glaucoma diagnosed

A comprehensive dilated eye exam is done for checking glaucoma. this is exam is simple and completely painless. Usually, there are no symptoms but people with glaucoma experience high eye pressure. Glaucoma is a cumulative ocular disease that leads to permanent vision loss by causing damage to the optic nerve which connects the brain and the eye. Performing comprehensive exams such as tonometry, tonometer or open, an optical coherence tomography (OCT) scan and visual field test helps in diagnosing glaucoma. If doctors address slight changes in your vision which can develop progressively and impact your vision doctors will immediately recommend you give a test for successive evaluation and treatment. once you know that you have been diagnosed with glaucoma you should take regular follow-ups and start your treatment as soon as possible. Tonometry exam helps in calculating intraocular pressure based on your eye response. During the tonometer test your eyes will get numbed so that the surface of the eye can be touched gently. is a non-invasive, diagnostic tool called OCT that uses a laser to provide colour-coded, cross-sectional images of the retina and optic nerve the last method is used to map the visual field for evaluating peripheral vision. Examination of the anterior angle (gonioscopy) and Optic disc examination are also performed for diagnosing the presence of glaucoma. if you suspect any symptoms or eye problems you should immediately see your doctor irrespective of your age and remember Glaucoma is a cumulative lifelong disease. Therefore it is important to take follow up appointment.

 

Q14. How is glaucoma treated?

Glaucoma cannot be reversed and a cure for glaucoma is yet to be discovered but there are treatments that can be beneficial in slowing down its effect. Anti-glaucoma eye drops are available which can be used for controlling the severe effects of glaucoma but eye drops will be recommended based on the type of glaucoma you are diagnosed with. There are many types of eye drops such as prostaglandins which relax the eye muscle by reducing build IOP and allowing better fluid drainage, beta blockers help decrease the amount of ocular fluid production, alpha-adrenergic agonists decrease the fluid production and can be used as a combination with other anti-glaucoma drops. Hyperosmotic agents are used in emergencies, for patients with a severely high IOP, Epinephrine increases its outflow from the eye and decreases the rate of ocular fluid production. For controlling IOP in narrow-angle glaucoma Epinephrine is prescribed and to decrease the rate of fluid production Carbonic anhydrase inhibitors are prescribed. For treating open-angle glaucoma selective laser trabeculoplasty (SLT) is performed because this is effective in lowering IOP by 20 to 30 per cent. Laser treatment is also performed for creating avenues for increased fluid drainage to reduce IOP. The effectiveness of eye s drops and selective laser trabeculoplasty is similar in most cases. surgeries like iridotomy which are performed for angle closure glaucoma and Trabeculectomy which is non-laser produce is performed for advanced cases of glaucoma

 

Q15. What is minimally invasive glaucoma surgery (MIGS)

Many of the surgeries are effective for lowering the risk of increased IOP level but Minimally invasive glaucoma surgery (MIGS) lowers your risk of surgical complication with the use of microscopic tools and devices and can only be performed with cataract surgery combination. the microscopic tube is inserted into the eye for enabling the proper fluid drainage involved in Micro trabeculectomies. iStent, PRESERFLO (formerly called InnFocus and Microshunt)  and Xen Gel Stent are different devices used for this procedure. Isent is performed very frequently for treating mild to moderate open-angle glaucoma. during this process, a small titanium micro trabecular device is implanted for creating a bypass through an anterior angle. This process enables the outflow of eye fluid by lowering IOP levels. Isents can be combined with cataract surgery For improving IOP, causing Minimal damage, reducing a patient’s medication burden, faster recovery and performance and also preventing the need for additional surgical interventions in the future. Another is glaucoma filtration surgery which is recommended for treating eraly and moderate stages of glaucoma. This process involves the implementation of tiny equipment and devices to cut trabecular meshwork without any harm. A tiny device is inserted into the eye using a special contact lens. This procedure is completely FDA-approved and effective in treating the advanced stage of glaucoma.  Suprachoroidal Shunts are successful in treating higher IOP levels and also beneficial in treating moderate to severe glaucoma. This procedure uses glaucous shunts, which are  tiny tubes with very small openings  and enable proper fluid drainage from the eye.

 

Q16. How Do Pressure Inside the Eye and Other Factors Effect Vision and Glaucoma

The risk of developing glaucoma increase with high eye pressure however it can occur in people with normal eyesight vision.  glaucoma develops because of the damage in the optic nerve, doctors usually s check the damage in the optic nerve to ensure successful treatment as once diagnosed with glaucoma it cannot be reversed and unfortunately the causes are still unknown. Normal glaucoma doesn’t include high eye pressure but there are signs of damage caused in the optic nerve. fluid pressure increases inside the eye and damages the optic nerve. In addition, it is also observed that people with higher than normal eye pressure do not always develop the symptoms of glaucoma. doctors can easily understand the impact of high eye pressure by examining your daily routine, lifestyle and medications. There is some factor that impacts the vision of the person. Glaucoma cannot be reversed but it can be prevented and we can slow down its effects with the help of treatment, a healthy lifestyle and medications. Some m symptoms might occurs due to the treatment of glaucoma. Age is the greatest risk factor for primary open-angle glaucoma. open-angle glaucoma refers to the group of glaucoma where the drainage angle of the eye is wide open, and eye pressure or intraocular pressure is the second major risk factor associated with glaucoma. Another factor also  include age as above 40 you will experience some symptoms of glaucoma  so it is often recommended to  take routine follow up after the age of 40 and above to treat glaucoma in the best possible way.

Q17. Will I go blind with glaucoma?

Yes, you can, glaucoma is the known cause of blindness that damages the optic nerve. Damage caused in the optic nerve can stop the transfer of signals from the eye to the brain to react. any compromise with the vision can lead lower the vision and lead to vision loss. it is a blinding disease and if not treated on time it can cause permanent blindness which cannot be reversed.   Blindness also depends on various factors and the severity of glaucoma as it developed gradually over time there are no eraly symptoms to diagnose this ut if you have any family history you should go for a regular check up after the age of 40. Once you get diagnosed with glaucoma it should be treated with medicine ton slower its impact otherwise it can lead to permanent vision loss. Therefore it is important to take follow-up appointments to observe the damages that occurred as peripheral or side vision can happen anytime. Follow helps to monitor the changes to manage the treatment. A follow-up appointment can differ in each case as it varies from person to person based on the factors like age and severity Appointment is prescribed based on the individual case. Adherence to the treatment and monitoring can lead to permanent blindness so the symptoms should not be ignored or kept for later. New improved treatment and medication  help in controlling by slowing its impact but the cause is still unknown.

 

Q18. Can glaucoma be treated with marijuana?

No, it is not recommended by optometrists and eye specialists to consume marijuana as a treatment for glaucoma. 1970 s students stated that consuming marihuana can help in lowing the IOP level but the effects last for a few hours. For the proper treatment of glaucoma, IOP must be lowered all the time for which one should consume marijuana all the time which is not recommended by eye specialists at all as excessive consumption of anything might cause other serious health problems. Consuming marijuana all the time will leave you unable to perform and concentrate and Doing so causes more damage than good so, in conjecture, using marijuana or weed can temporarily lower your eye pressure, but it is not recommended as a treatment for Glaucoma nor it is prescribed by any doctor or eye specialist. Marijuana can treat pain, depression, anxiety, seizures, psychosis and insomnia but not glaucoma as for controlling glaucoma the IOP level should be in control and lowered all the time. marijuana can cause cloud damage to the optic nerve. It is not legal either most of the people could afford this.

 

Q19. Can I have glaucoma from diabetes?

Glaucoma refers to a group of eye conditions that damages the optic nerve which is essential for eye health and any damage caused to the optic nerve left untreated leads to permanent blindness. Glaucoma is based on high pressure. Diabetic retinopathy is a complication of diabetes and it is true that diabetic eye disease can lead to the development of glaucoma. The relationship between diabetes, blood pressure and glaucoma is not established but a controlled blood sugar level helps in maintaining a healthy lifestyle which can prevent conditions like glaucoma and cataract in adulthood.  Diabetic retinopathy affects the people who have mediates and further, it can lead to the development of glaucoma as well. in short we can say that people with diabetes are at a higher risk of developing glaucoma. Diabetic retinopathy leads to changes in the glucose level that weaken the retina and damage which eventually lead to glaucoma. When the blood vessels get damaged it leads to the formation of new blood vessels which is known as neurovascular glaucoma. This formation of the new blood vessels blocks the drainage in the eye and damages the optic nerve which as a result increases the risk of glaucoma and vision loss. diabetic patients suffer from high blood sugar levels which is the direct cause of glaucoma because it causes fibronectin which increases in a specific glycoprotein. Having a higher level of fibronectin solo blocks eyey natural drainage system and cause glaucoma. The reason and the cause are still unknown as already discussed it has no symptoms at the early stage which is very difficult to get diagnosed

 

Q20. Will the vision be restored after the treatment?

No glaucoma treatment cannot restore the lost vision but I can be controlled with the help of medications and techniques. Once diagnosed and treated on time cannot restore the lost vision but it can for sure preserve the remaining vision. Some m symptoms might occurs due to the treatment of glaucoma. Age is the greatest risk factor for primary open-angle glaucoma. open-angle glaucoma refers to the group of glaucoma where the drainage angle of the eye is wide open, eye pressure or intraocular pressure is the second major risk factor associated with glaucoma and all the current glaucoma treatments considered eye pressure through surgery, laser or medications Glaucoma has n no symptoms in its early stage and by the time symptoms occur occasional it will make the vision worst and a large amount of the vision will be lost. so if you already have glasses or you use contact lenses you should go for the monthly check up as recommended by your doctor to catch glaucoma at the early stages. You should not ignore thinking about the fact that glaucoma affects only people belonging to the age above 40 or 60 as it can affect anyone belonging to every age group. In simple words, glaucoma slowly damages the eyes and leads to vision loss which is irreversible and irreparable. Majorly glaucoma is a age-related disease and regaining visual function after the injury is still not demonstrated by the scientist