DR.DALJIT SINGH EYE HOSPITAL ,AMRITSAR
GLAUCOMA ( also known as KALA MOTIA in Hindi , JHAAMAR in Gujarati and also KANCHIA MOTIA BIND  )


Glaucoma earned the nick name of kala Motia because patients affected this lost all vision and their world became Black.

What is Glaucoma ?

Our eye is like a ball filled with fluid . This fluid is continuously being produced in the eye. At the same time the fluid is being drained out of the eye. A balance between the volume of fluid being produced and the volume of fluid drained from the eye maintains a dynamic pressure of fluid in the eyeball , known as intra ocular pressure or IOP. Acceptable IOP limits are between 15 mm of Mercury to 22 mm of mercury. 
If the amount of fluid being prodded increases or if the amount of fluid being drained out decreases or if there is any obstruction to the movement of fluid inside the eye , the pressure of fluid in the eye or IOP increases. This increase in pressure is known as Glaucoma. So glaucoma is not a physical material but simply a state of increased pressure of fluid inside the eye.

Types of Glaucoma :

Following are some broadly accepted types :

a) Chronic Simple Glacucoma : In this the IOP of the eye is raised but is not so high enough for the patient to notice anything is wrong in his eyes. This may be detected only during routine eye checkup . If this raised pressure continues for a prolonged period of time , gradual damage of the optic nerve of the eye takes place and ultimately all of vision is lost. Some patients can experience seeing rainbow like ring around light sources. It is important not to ignore this and seek treatment .

b) Narrow angle glaucoma : In this there is obstruction to the drainage of the fluid from the eye . Pressure increase is sudden and often very high , sometimes to the level of 50-60 mm of mercury. A patient with this glaucoma would feel intense eye pain , nausea , vomiting and blurring of vision . Because of pain , this type of glaucoma may be detected early on and treatment started in time.

Investigation of a case of glaucoma :

a) Measurement of IOP with an instrument known as tonometer. Any IOP reading above 22 mm of mercury should be looked at suspiciously . Before labeling a patient as having glaucoma , borderline patients most be tested repeatedly to make sure that IOP stays high .

b) Optic nerve head check : Doctor checks the optic nerve with an ophthalmocope . An optic nerve damaged due to glaucoma can usually be detected easily and advanced tests can be done to quantify the damage if any. 

c) Computerized automated field analysis : This helps us in charting the field of view of the eye and hence telling us about the function of the eye . Any loss of field of view can help us in diagnosing early cases of glaucoma and also help in monitoring and change over a period of time.

d) Retinal Nerve Fibre Analysis :This helps us in knowing the amount of nerve fibres entering the optic nerve and thus telling us about the structure of the optic nerve. A lower RNFL reading is usually indicative of optic nerve damage.


Treatment of Glaucoma :

a) Medical treatment : Several eye drops can be used reduce the IOP of the eye and thereby prevent further damage. In spite of the pressure staying normal , a patient of glaucoma needs to get his eyes tested every now and then on a regular basis to avoid any surprises.

b) Operation : Glaucoma can be treated with surgery too but operation is reserved for patients where even inspire of using maximum medicines , the pressure cannot be controlled or the patient cannot afford expensive medicines or if the patient is not regular in the use of medicines.

c) Laser Peripheral iridectomy : A laser is sometimes used to assist in the treatment of glaucoma by making a small hole in the iris .

Points to remember :

Glaucoma is often a life long problem and needs life long care. If done properly , patients of glaucoma can enjoy good vision for a life time . If not , vision can be lost irretrievably forever.

At Dr.Daljit Singh Eye Hospital , we are doing minimally invasive glaucoma surgery with the use of a novel instrument known as the Fugo Blade. 

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Watch a video of Glaucoma Surgery with The Fugo Plasma Blade by clicking HERE