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What is glaucoma?

It is a condition that cause damage to the optic nerve, which transmits information from the eye to the brain. It usually (but not always) is associated with high intraocular pressure (IOP). Left untreated, glaucoma can cause blindness.

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What are the symptoms of glaucoma?

There are usually no symptoms that you're developing glaucoma until vision loss occurs, which is why it's so important to have regular eye checkup. Your eye doctor can detect and treat high IOP before it progresses to optic nerve damage and vision loss.

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How glaucoma is diagnosed?

During the routine eye checkup, the IOP (intraocular pressure) will be measured by tonometry (NCT-non-contact tonometry) and dilated fundus examination will be done. If the IOP is found to be on the borderline or on the higher side by NCT, the IOP will be again measured again by applanation tononmetry since it is more accurate for diagnosing glaucoma.

Pachymetry will be done to measure the corneal thickness. If the IOP is high associated with optic nerve damage, visual field test will be done. If this test shows defect, then glaucoma is confirmed.

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Is glaucoma curable?

Vision loss from glaucoma cannot be reversed. Routine eye exams are essential to discover glaucoma early and begin glaucoma treatment before significant vision loss has occurred

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Is glaucoma preventable?

Risk of glaucoma can be reduced by healthy life style (ie) avoid smoking and alcohol intake.

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What are the different types of glaucoma?

There are two main forms of glaucoma: open-angle (the most common form, affecting approximately 70-90% of individuals); and angle-closure. There are also several other forms of glaucoma, including normal-tension, congenital, juvenile, and secondary

OPEN ANGLE GLAUCOMA

This is the most common form of glaucoma which is progressive and causes optic nerve damage. The most significant risk factor for the development and progression of this form is high intra ocular pressure. Initially, there are usually no symptoms, but as eye pressure gradually builds, at some point the optic nerve is impaired and peripheral vision is lost. Without treatment, an individual can become totally blind.

ANGLE CLOSURE GLAUCOMA

It occurs due to the closure of anterior chamber angle. Angle-closure glaucoma may be acute or chronic. In acute angle closure (also called closed angle) glaucoma, the normal flow of eye fluid (aqueous humor) between the iris and the lens is suddenly blocked. Symptoms may include severe pain, nausea, vomiting, blurred vision, and seeing a rainbow halo around lights. Acute angle-closure glaucoma is a medical emergency and must be treated immediately, or blindness could result in one or two days. Chronic angle-closure glaucoma progresses more slowly and can damage the eye without symptoms, similar to open-angle glaucoma

Normal-tension glaucoma

Normal-tension glaucoma occurs when eye pressure is normal, yet the optic nerve is damaged and peripheral vision is lost. Lowering eye pressure through medication sometimes slows the progress of the disease, but this type of glaucoma may worsen despite low pressure.It is advisable to rule out cardiac problems. The treatment is generally the same as for open-angle glaucoma.

Congenital Glaucoma

This affects infants born with defect in the normal drainage of fluid from the eye

Juvenile Glaucoma

Juvenile glaucoma is open-angle glaucoma that affects children, adolscents, and young adults

Secondary glaucoma

This form of glaucoma occurs due to preexisting ocular diseases like trauma to eye or any inflammation of eye or any degenerative changes in eye.

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What is the treatment for glaucoma?

Doctors usually prescribe special glaucoma eye drops that reduce intraocular pressure. These are used one or several times a day, depending on the medication.

Occasionally oral medication are prescribed in oder to reduce intraocular pressure

Laser surgery: During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This surgery results in a series of small changes that make it easier for fluid to exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drugs.

If the drops and laser don't work, surgery may be the next step. In some cases, surgery might be the first option for glaucoma treatment.

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How long medications are to be used for glaucoma?

Glaucoma medications are to be put lifelong to prevent optic nerve damage. If pressure remains uncontrolled by drops then anti glaucoma surgery ( trabeculectomy )will be done. If iop is well controlled and there is no progression of optic nerve damage after surgery,then medications can be stopped.

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Is glaucoma hereditary?

The most common type of glaucoma, primary open-angle glaucoma, is hereditary. If members of your immediate family have glaucoma, you are at a much higher risk than the rest of the population.

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How frequently a glaucoma patient should visit an ophthalmologist?

The frequency and the composition of follow-up evaluation depend on the age of the patient, the level of elevation of IOP, the appearance of optic nerve head cupping, a family history of glaucoma, the presence of additional risk factors, and the stability of the patient's clinical course. IN general and depending on the patient's risk factors, check IOP every 3-12 months.

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Who are at risk for glaucoma?

Some people have a higher than normal risk of getting glaucoma. This includes people who

are over age 40

have family history of glaucoma

have high eye pressure

have had an eye injury

have corneas that are thin in the center

have thinning of the optic nerve

have diabetes, migraines, poor blood circulation or other health problems affecting the whole body

People with more than one of these risk factors have an even higher risk of glaucoma

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What is the normal IOP?

Eye pressure is measured in millimeters of mercury (mm Hg). Normal eye pressure ranges from 10-21mm Hg.

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What causes glaucoma?

The passages that normally allow fluid within your eye to drain become clogged or blocked. Fluid within your eye then builds up and increases pressure on the optic nerve. The nerve fibers and blood vessels in the optic nerve are easily damaged by this pressure, resulting in vision loss.

An injury, infection or tumor in and around the eye ,matured cataract can increase the intraocular pressure.

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Will vision be restored after surgery?

Unfortunately, any vision loss due to glaucoma usually cannot be restored. This is why regular preventive eye examinations are so important. Low-vision rehabilitation services, which include the use of specialized optical devices and training, may benefit people with severe vision loss from glaucoma.

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How is glaucoma harmful to vision?

The optic nerve, at the back of the eye, carries visual information to the brain. As the optic nerve fibers are damaged, the amount and quality of information sent to the brain decreases and a loss of vision occurs.

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Will I go blind from glaucoma?

If diagnosed at an early stage, glaucoma can often be controlled with little or no further vision loss. If left untreated, first peripheral vision and then central vision will be affected, and blindness may result.

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What are the signs and symptoms of glaucoma ?

The signs or symptoms of glaucoma can vary depending on the type

Primary open-angle glaucoma often develops slowly and painlessly, with no early warning signs. It can gradually destroy your vision without you knowing it. The first indication that you have glaucoma may occur after you've already lost some vision.

Acute-angle closure glaucoma results from a sudden blockage of drainage channels in your eye, causing a rapid buildup of pressure. In this form of the disease you will have blurred vision, the appearance of halos or colored rings around lights, and pain and redness in the eye.

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What should be done if I forget to put my eye drops on time ?

It is very important to take your eye drops consistently (compliance). Inconsistent use of drops will cause pressure fluctuation (diurnal variation) in the intraocular pressure (IOP) and causes more damage to optic nerve.. Therefore, when you miss a morning dose of your medicine, take it later in the day when you remember. If you forget your evening dose, use it in the morning when you remember. It is advice to take the drops in time

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What medications should I avoid when putting glaucoma drugs?

In narrow angle glaucoma it is better to avoid anticholinergic it is better to consult your physician before taking any drug

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When my eyes feel dry, can I take more of my glaucoma drops?

In many instances, the glaucoma drops themselves have a side effect of causing dry eyes. Increasing their use would not only exacerbate the dryness but also not follow the prescribed dosing interval.

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When my blood pressure goes up, what happens to my eye pressure?

If someone were to raise your blood pressure your eye pressure might go up immediately. Just as quickly your eye would compensate for this and return your eye pressure to its usual level . However, increased blood pressure over a longer period of time could lead to decreased circulation to your eye which would be detrimental to the glaucoma.

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What is the ideal eye pressure for me?

Every individual has a unique pressure that is good for their eye. Whereas one person may have a pressure of 29 and be on no drops, another person may have a pressure of 15 and going blind. Each person should ask their physician what their ideal pressure is — a goal which is determined by each person's unique history, exam, and testing. One size does not fit all when it comes to a pressure target.

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Will glasses help with glaucoma?

Glasses do not directly help glaucoma,using glasses cannot restore the vision loss occurred due to glaucoma.

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Do I need to put the drops in before I come to the clinic?

Yes. Always continue as usual unless requested otherwise. It helps the doctor to judge the effect of the treatment.

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How important is it to put the drops in at exactly the time stated?

It is important to get into a routine and to put the drops in at around the same time each day, but the exact time is less important.

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Is it safe to put in an extra drop just to make sure?

Yes, if you are not certain that the first drop went in, it is safe to put in another drop. In general, it is best to avoid putting in more than one drop.

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What happens if I forget to take my drops when I go out?

Do not worry unduly if you forget on the odd occasion, but try to get into the habit of taking your drops with you wherever you go. If you have forgotten a drop, just put it in as soon as possible after the time it was due.

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Where should I keep the drops and for how long?

Keep your drops in a cool place or in the door of the refrigerator, which is cool but not as cool as if they were put on one of the shelves. Do not place them in the freezer section.The unopened bottle will have an expiry date. Once opened, drops will last about four weeks.

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Can strong sunlight affect primary open angle glaucoma?

No, but if eyes are sensitive to strong light, then sunglasses can be helpful.

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Can I take other medicines at the same time as my glaucoma treatment?

Patients with angle closure or narrow angle types of glaucoma should seek advice before taking some types of tranquilliser or certain asthma and indigestion medicines. However, these are usually safe if you have had laser treatment (iridotomy) or surgery (peripheral iridectomy).Steroid (cortisone-type) drops and tablets should be used with caution because they can increase the pressure in the eye. If you have had a glaucoma operation, steroid drops or tablets are safer.

Some other tablets may interact with glaucoma treatments. Always mention to your doctor that you are having glaucoma treatment and your doctor will advise you

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Should I let my eye doctor know if I develop other medical conditions?

Yes. It may influence the treatment they prescribe you. Please remember that eye drops are powerful medications and that they can interact with other treatments.

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Why do I have to see the eye specialist or attend the glaucoma clinic regularly?

It is important to attend regularly, even if your glaucoma is stable. The purpose of your visits is to monitor the glaucoma (through optic nerve appearance, visual field and eye pressure tests) to ensure that the treatment is working.