Glaucoma Treatment Pune


Since vision loss due to glaucoma is irreversible , the goal of glaucoma treatment is to control progression of vision loss after early diagnosis .It could be treated with eyedrops , pills , laser surgery, traditional or conventional surgery , or combination of surgeries.

After instilling any antiglaucoma eyedrop , close your eyes for 1-2 mins & press index finger lightly
against inferior nasal corner to close tear duct which drains into nose . This is to maximise the
amount of drug absorbed in the eye & minimize absorption into bloodstream .

If IOP is not controlled with eyedrops , pills are used in addition to eyedrops . pills need to be
administered 2 – 4 times /day as requirement . They do have systemic side effects , hence prior
systemic evaluation & history of any pre existing illness required before administration of pills .

When desired results are not achieved with medications or patient experiences intolerable
side effects , then surgical correction is needed .
It is an intermediate step between drugs & traditional surgery (TRABECULOPLASTY ).It is used to
Treats trabecular meshwork of the eye increasing aqueous drainage outflow , thereby decreasing
intraocular pressure
Newer laser which uses low energy , selects part of trabecular meshwork & leaves few parts
intact,unlike other types , it can be safely repeated .

through iris , allowing aqueous fluid to flow from behind the iris , directly into Anterior chamber of
the eye , thereby fluid bypasses its normal route .

*CYCLOABLATION –Transcleral cyclophotocoagulation uses a laser to direct energy through outer
sclera of the eye to reach & destroy portions of ciliary processes without damaging overlying tissues
With Endoscopic cyclophotocoagulation instrument is placed inside the eye , through surgical
incision , so laser energy is applied directly to ciliary body .

*TRADITIONAL SURGERY –Conventional surgery TRABECULECTOMY is preferred when medication &
laser treatment do not adequately lower Intraocular pressure . It is used in Open as well as Angle
closure glaucoma . Surgeon creates passage in sclera for draining excess eye fluid.Flap is created to
allow the fluid to escape , but does not deflate the eyeball . On superior surface of eyeball over
limbus , small bubblle of fluid called BLEB is created , which ios a sign that fluid is draining into space
between sclera & conjunctiva . Ocassionally the BLEB closes & IOP rises since the body tries to heal
the opening targeting it as injury.Hence many surgeons use antifibrotic agents like Mitomycin C or
5 FU during surgery to prevent scarring .50% patints do not require Antiglaucoma medication for
significant length of time post surgery .

* DRAINAGE IMPLANT SURGERY – Several types of drainage devices are available which have a
similar design consisting of small silicone tube that extends into anterior chamber of the eye .The
tube is connected to one or more plates which are sutured to surface of the eye .Fluid is collected on
plate & absorbed by tissue in eye preferred in patients whose pressure is not controlled by
trabeculectomy or who have previos scarring

* NON PENETRATING SURGERIES -It is a promising surgery in future, since it minimizes post
operative complication , lowers risk of infection as it does not enter Anterior chamber ., but it
requires greater surgical Acument. Furthermore longterm studies are neededto assess these
procedures & to determine their role in clinical management of glaucoma patients .

1)EXPRESS MINIGLAUCOMA SHUNT -stainless steel like device inserted into Anterior chamber of eye
& placed under scleral flap .It offers an alternative to either repeating Trabeculectomy or placing a
more extensive silicone tube shunt in patients whose IOP is higher than the optic nerve can tolerate
2) TRABECTOME – New probe like device that is inserted into anterior chamber through cornea . It
delivers thermal energy to trabecular meshwork , reducing resistance to outflow of aqueous humour
, resulting in reduction of IOP
3) CANALOPLASTY – Recent advancement in non penetrating surgery. It is compared to an ocular
version of Angioplasty in which physician uses extremely fine catheter to clear drainage canal


For more information take appointment today itself with Dada Laser Eye Institute !



Various factors can give rise to cataractous changes in the natural lens of the eye . Few of the main factors listed
below which cause the cataract.

*AGE -Cataract develops as age advances , mostly begins after 55 yrs but could be seen in patients at
an early age also, depending upon physical status & predisposing risk factors
*DIABETES MELLITUS – It is a risk factor for cataract . Patients who have diabetes have the risk of
developing cataract at an early age .
* EXCESSIVE EXPOSURE TO SUNLIGHT – Ultra violet rays exposure from direct harsh sunlight can
cause early development of cataract . Sunglasses can act as a protection from direct sunlight .
* SMOKING /DRINKING ALCOHOL – It is again a predisposing risk factor for early development of
*OBESITY -Obesity is a predisposing risk factor for Diabetes & other systemic illness , therefore
could give rise to early development of cataract .
*HIGH BLOOD PRESSURE –Blood pressure should be well under control in order to prevent cataract
*PREVIOUS EYE INJURY OR INFLAMMATION –any kind of direct blunt trauma could give rise to
traumatic cataract even in young patients . Also inflammatory diseases of the eye like uveitis could
add to complicated cataract .
*PREVIOUS EYE SURGERY-Any form of previous eye surgery lcould predispose to lenticular changes
giving rise to early development of cataract .
*PROLONGED USE OF CORTICOSTEROID MEDICATION- Any form of oral of topical steroid treatment
for a longterm period of 6months – 1 year could give rise to cataract.

for more queries take your appointment today with Dada Laser Eye Institute and talk with experienced surgeon
Dr. Jeevan Ladi.