Glaucoma Treatment
What is glaucoma or ‘kala motia’?
Glaucoma or ‘Kala Motia’ occurs when the eye pressure increases and damages the optic nerve leading to impairment of visual acuity. Of all the conditions prevailing in the human eye, glaucoma is one of the most threatening ones. Glaucoma is also known as a ‘silent thief of vision’ as it has often no symptoms and may go unnoticed in the early stages.
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Glaucoma symptoms
Slow often unnoticed decrease of vision
Headaches accompanied by redness and pain in the eyes.
Rapidly changing glass prescription
Reduced vision in low light conditions or at night
Seeing colourful haloes or rings around bulbs
Who is at risk for glaucoma?
People above the age of 40 years
Patients with hypertension, migraine or diabetes
Patients having high powered glasses ( plus or minus)
Patients on long term steroids for other ailments
Patients who have undergone previous eye surgery
Patients with a history of eye trauma/ injury
Those who have a family history of glaucoma (kala motia)
If a close relative has it, then you should definitely get yourself checked for glaucoma
Types of glaucoma (kala motia)
Glaucoma may be classified as open-angle or closed-angle or mixed/ secondary type of glaucoma.
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Primary open-angle glaucoma
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It is widely known as open-angle glaucoma and is the most common form of glaucoma. It is caused by increased eye pressure which slowly causes damage to the optic nerve and consequent vision loss. Classically the filtration angle (an area between the cornea and iris through which the aqueous humour filters out of the eye) is open. The patient may have high pressure or a vague feeling of heaviness. Associated features may include headache or decrease in vision. Often it is asymptomatic and the patient may not feel anything.
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- When you visit the eye doctor at Centre for Sight for these complaints the medical staff will take your history and record your vision and eye pressure. The doctor will then examine you and recommend tests if needed. Your eye pressure will be recorded by Applanation Tonometry and the optic disc (nerve of the eye) will be examined for any variation in size as compared to normal. A visual field test will be advised to evaluate the function of the optic nerve. An OCT may be advised to see the thickness of the optic nerve fibres. A corneal thickness measurement will be done. A gonioscopy will be performed to look at the angle. A colour picture of the optic nerve may be needed to document the size of the optic nerve. Depending on the condition of your eyes, the doctor may advise some or all of these tests for a detailed evaluation.
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Open-angle glaucoma treatment
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Once the patient has been investigated and the diagnosis of open-angle glaucoma is confirmed, efforts are made to lower the eye pressure using eye drops. There are various kinds of eye drops and the doctor will choose the best drop for you depending on associated conditions such as asthma, diabetes, inflammation in the eye etc. Sometimes additional medicines in the form of tablets, syrups and injections may be given for short term to improve the pressure control.
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- Other options such as lasers, surgery and filtration devices can be considered for patients not responding or not controlled with eye drops alone.
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Angle-closure glaucoma
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Angle-closure glaucoma is a type of glaucoma in which the drainage area or angle is closed or narrow. Consequently the aqueous humour or fluid inside the eyes cannot drain out normally which leads to a rise in eye pressure. This may lead to pain in the eye, redness, decreased vision and coloured halos around light. Angle-closure glaucoma may have acute symptoms and need immediate attention in the form of medicines and laser to relieve the acute attack. Some patients may have dull, low-grade pain in case of chronic angle-closure glaucoma
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- When you visit the eye doctor he will examine your eyes as discussed above and recommend some tests based on your eye condition. He will assess whether you need any immediate treatment or a regular follow up.
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Closed-angle glaucoma treatment
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Routine, periodic eye checkups will help your doctor assess whether you are at risk of angle-closure glaucoma. Your doctor will perform some tests to see if you have any signs of closed-angle. In case the eye pressure is very high, medicines in the form of tablets/ syrups and eye drops will be given. A laser may be recommended to create an alternative opening to relieve the angle closure and allow fluid to pass through and open the blockade (YAG PI). Patients who do not respond to lasers and medicine will need surgery (glaucoma filtration surgery).
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Secondary glaucoma
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Secondary glaucoma develops as a result of other eye conditions such as trauma or injury or complicated surgery, inflammation, use of certain drugs like steroids, etc. Sometimes it may be due to pigment release from the eye (pigmentary glaucoma) or due to deposition of flaky material (pseudo-exfoliative glaucoma) It will need treatment depending on the cause of glaucoma.
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Steroid-induced glaucoma
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Excessive and prolonged use of steroids either locally in the eye or systemically for other conditions can lead to steroid-induced glaucoma in vulnerable people. Patients with family history, myopia and diabetes etc. may be more at risk for developing this condition. Avoiding steroids for a long duration is essential. Treatment involves lowering the eye pressure and minimizing steroid use.
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Traumatic glaucoma
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Traumatic glaucoma occurs due to direct or indirect injury to the eye. It may occur immediately after trauma or even years later. Sometimes it may be difficult to treat with medication alone and may need surgery to control the elevated intraocular pressure.
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What is the treatment for glaucoma (kala motia)?
- Glaucoma or ‘kala motia’ can be controlled with appropriate treatment. Centre for Sight recommends disciplined and regular treatment to tackle glaucoma (kala motia). We have one of the best glaucoma specialists to help you diagnose and manage this eye condition and treat it to the best extent possible.
Glaucoma treatment: Why Centre for Sight?
Affordable cost of treatment
Team of experienced surgeons
All facilities under one roof
Use of state-of-the-art technology and the latest equipment
Impressive success rate
At Centre for Sight, with our team of super specialists and advanced state-of-the-art technology, we are fully geared not just to detect early stages of glaucoma or ‘kala motia’ but to ensure comprehensive treatment and surgical management.
Since most people with glaucoma (kala motia) have no early symptoms or pain, it is important to see your eye doctor regularly. As part of glaucoma treatment, early detection and diagnosis play a critical role in preventing irreversible sight loss.
If you are over 40 years of age and have a family history of glaucoma, you should have a complete eye exam at a hospital that specializes in glaucoma treatment every one to two years.
The glaucoma treatment at Centre for Sight aims to preserve the remaining vision of the patients by lowering IOP (intraocular pressure) so that damage does not escalate.
Diagnosis and screening during glaucoma treatment
The most advanced and sophisticated technology at Centre for Sight helps our team of competent doctors to assess
the optic nerve structure and function, measure eye pressure and evaluate the sensitivity or susceptibility of the eye
to glaucoma damage.
Tonometry for Eye Pressure Measurement
Tonometer is a device used for checking intraocular pressure or eye pressure. It may be checked using Applanation tonometry (AT) for confirming the eye pressure and Non-contact Tonometry (NCT) for screening purposes.
Ophthalmoscopy for Optic Nerve Damage
The eye specialist will assess the optic nerve status including the colour, shape, depth, and size of the optic nerve head to determine the overall health of the optic nerve. Ophthalmoscopy involves taking the 3D view of the optic nerve for better assessment. The test takes around 5-10 minutes and may be done with or without dilation.
Pachymetry For Cornea Thickness
Corneal thickness is measured using a pachymeter. Measuring the corneal thickness is important as people with low corneal thickness would be more vulnerable to glaucoma damage even at low eye pressure and need a more intensive pressure control to prevent glaucoma damage.
Perimetry to measure the field of vision or Visual Fields
Perimetry is used to map the field of vision or the entire area you see right in front of your eyes without moving your eyes. This is the most important test for glaucoma as it helps your doctor to assess the extent of damage of the optic nerve due to glaucoma. Often this damage is irreversible. Patients with damage to their visual field need to be very careful with their medicines as we need to preserve whatever vision is left.
Gonioscopy to assess the drainage area or Filtration Angle
This test uses a hand-held lens used with or without a coupling fluid to look at the filtration angle or area involved in drainage of aqueous humour. The doctor puts some numbing eye drops and places the lens to look at 360 degrees of the angle. In patients with angle-closure glaucoma, the angle will be narrow or closed and in open-angle glaucoma patients, the angle will be open. Patients with narrow or closed angles may be recommended a laser (YAG PI) to open the angles.
OCT or Optical Coherence Tomography
OCT is a very sensitive and sophisticated imaging technology to assess the optic nerve status. It measures the retinal nerve fibre layer (RNFL) thickness, the optic nerve head (ONH) dimensions and the ganglion cell complex (GCC) parameters. Often it can detect glaucoma much earlier than other tests before even the visual field changes have appeared. It is important not only for screening and confirming the diagnosis but also to monitor the treatment. Your doctor will recommend this test depending on your eye condition and will then analyze the report to advise the best treatment for you.
Three approaches adopted by the specialists at Centre for Sight for glaucoma treatment
| Medication | Laser | Surgery |
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| If the patient’s condition is manageable by medicines, the specialists prescribe eye drops, tablets, syrups, or injections. | Different types of lasers are used to treat glaucoma depending on the type and stage of glaucoma. | Surgeries are recommended for patients unresponsive or uncontrolled with medicines and lasers. |
Glaucoma lasers and surgery
The most commonly performed laser for glaucoma is the YAG peripheral iridotomy (YAG PI). It is performed in patients with narrow or closed angles. It needs to be performed usually in both the eyes to prevent an acute rise in pressure or an ‘attack’ of glaucoma. The patient may or may not need additional medicines after a YAG PI.
Laser trabeculoplasty using an Argon or YAG laser may be performed at select places to improve the pressure control.
Glaucoma surgery involves creating an alternative filtration channel to drain the aqueous and control the pressure. Trabeculectomy (or Trab as it is commonly called) is the standard glaucoma surgical procedure. In trabeculectomy, the surgeon creates an alternative filtration opening under a scleral and conjunctival flap to drain out the aqueous and control the pressure.
We also have several new techniques in glaucoma surgery like implanting a valve or glaucoma filtration device (for controlled filtration) and the use of sophisticated vitreoretinal methods to help to perform complicated glaucoma procedures. These techniques of surgery provide tremendous hope to patients with advanced and uncontrolled glaucoma.
Glaucoma surgery cost at Centre for Sight
Glaucoma surgery cost depends on the kind of treatment a patient is opting for and thus will vary from surgery to surgery Centre for Sight endeavours to perform the most cost-effective and contemporary surgery to suit every patients’ Specific needs with the utmost care and compassion.
Our centres across the country in Cities including Delhi, Gurgaon, Hyderabad, Indore, Jaipur and others, are easily accessible to people in need of the latest glaucoma treatment. With a panel of highly experienced glaucoma specialists Centre for Sight is the right choice for the treatment of glaucoma across the country.
Contact us today to know more about glaucoma surgery cost, laser treatment for glaucoma, or any other glaucoma related issues..
What are the early signs of glaucoma?
Glaucoma (kala motia) is a silent disease. Most people will not have any significant symptoms. Occasionally someone may feel vague eye ache, especially in the evening and in dim light conditions. Other symptoms include redness, watering, coloured halos around light, and blurring of vision.
Can glaucoma (kala motia) be cured completely?
Glaucoma can be controlled in more than 90% cases. Just like many other chronic diseases, we can prevent glaucoma from progressing further with medicines, but it needs regular monitoring. Combination of medicines, lasers and surgery where needed helps to provide relief to most patients.
What should glaucoma patients avoid?
Glaucoma patients should avoid taking steroids in any form and, if needed, must inform their doctor that they have glaucoma. Self-medication should be avoided at any cost. Besides, avoid excessive tea or coffee intake. Avoid consuming large quantities of water/fluids in one go.
Is coffee bad for glaucoma?
Excessive coffee (more than 2-3 cups a day) is associated with elevated eye pressure and is best avoided.
How to get rid of eye pressure?
You need to get yourself examined by a glaucoma specialist, who will perform a couple of tests to measure the eye pressure and check if it is elevated. Depending on the measurements, the glaucoma specialist might recommend a few eye tests followed by appropriate treatment. Laser treatment for glaucoma is also one of the ways to treat glaucoma and is done on an outpatient basis.
Can you reverse glaucoma?
Glaucoma (kala motia) cannot be reversed, but further damage can be stopped. Only in some cases like children, early intervention may sometimes reverse the damage and restore an improved visual field or optic nerve function.
Can glaucoma medications produce side-effects?
Yes, the side-effects of glaucoma medications can be seen in some people. The anti-glaucoma eye drops may cause an itching sensation, redness in eyes, increased heartbeat, dry mouth, eyelash growth, noticeable change in eye colour and the skin around it, irritation etc.
Does exercise play any role in glaucoma?
Doing exercise is healthy for the body. For a patient suffering from glaucoma, there are a few aerobic exercises that can safely be done 3-4 times in a week for a minimum of 25 minutes. These include swimming, jogging or walking or riding a bike. However, patients with advanced glaucoma should avoid exercises like weight lifting or push-ups which cause a lot of strain. Certain yogic postures like shirshasana (where the head is below the body) are also best avoided.
How does glaucoma medication affect the baby?
One should always keep in mind that glaucoma medications may have a high chance of affecting the fetus. Pregnant women with glaucoma should inform their doctor and take medicines only under supervision.
Can glaucoma occur in a baby?
Glaucoma may be present at birth or may develop shortly after and is known as congenital glaucoma. Such children may have large eyes which may appear bluish, watering and tendency to avoid light (photophobia). It is more common in families where marriages occur between relatives and cousins (consanguinity). It needs immediate attention to prevent permanent damage to eyesight.
Does working on a computer or mobile worsen my glaucoma or eye pressure?
No, it does not. As long as you’re putting your eye drops regularly and getting check-ups done as required, you are free to use digital screens as much as you comfortably can. It is a good idea to take a break between long hours of work to prevent eye muscle fatigue
