Glaucoma - Diagnosis And Treatment Options

Glaucoma causes optic nerve damage due to fluid buildup in the eye. If not treated, this eye pressure can permanently impair vision. Glaucoma may be the world’s second leading cause of blindness. Eyedrops, laser treatments, and surgeries can all help to slow vision loss and save your sight. The most common type, open-angle glaucoma, manifests slowly and is difficult to detect. An ophthalmologist, on the other hand, may identify changes during an eye exam. Glaucoma has no cure, but treatment can slow or stop its progression.

Glaucoma is often referred to as the “silent thief of sight” because most types cause no pain or symptoms until noticeable vision loss occurs. As a result, glaucoma frequently goes undetected until the optic nerve is irreversibly damaged. Though the exact cause of glaucoma is unknown, several factors can increase one’s risk. Age, ethnicity, family history, racial background, and various medical conditions such as short-sightedness and diabetes are among them. It affects people of all ages, but it primarily affects adults.

In this article, you will learn more about glaucoma, its treatment options, and how glaucoma gets diagnosed.

What Is Glaucoma?

Glaucoma is a broad term that refers to a group of eye disorders that cause damage to the optic nerve. It is the most common type of optic nerve damage that results in vision loss. In most cases, fluid accumulates in the front of the eye. This extra fluid puts pressure on the eyes, gradually causing optic nerve damage. It is known as intraocular pressure (IOP), also known as eye pressure. Some people with normal eye pressure develop glaucoma.

In most cases, glaucoma remains associated with higher-than-normal intraocular pressure, a condition known as ocular hypertension. However, it can also happen when the intraocular pressure (IOP) is regular. Glaucoma, if left untreated or poorly controlled, can cause permanent and irreversible vision loss and blindness.

Read More: What Is Glaucoma? Causes, Symptoms, Treatment, Surgery & Prevention

Glaucoma Diagnosis

An ophthalmologist (eye doctor) can usually detect people who are at risk for glaucoma (for example, because of a narrow drainage angle or increased intraocular pressure) before nerve damage occurs. The doctor can also diagnose glaucoma in patients who already have nerve damage or visual field loss. The following tests, all of which are painless, could be included in this evaluation.

Your doctor will go over your medical history and perform a thorough eye examination. They may conduct a variety of tests. Here is the list of Glaucoma Diagnosis procedures:

  • Tonometry

Tonometry measures the tone or firmness of the surface of the eye to determine its pressure. This test can get performed using many tonometers, the most common of which is the applanation tonometer. The tonometer’s sensor gets placed against the front surface of the eye. It gets done after numbing the eye with anesthetic eye drops. The higher the pressure reading, the firmer the tone of the eye’s surface.

  • Ophthalmoscopy

Ophthalmoscopy is an examination in which the doctor looks directly into the eye through the pupil (the opening in the colored iris) using a handheld device, a head-mounted device, or an appropriate lens and the slit lamp. The optic nerve or the optic disc at the back of the eye gets examined during this procedure. This method can detect damage to the optic nerve, known as cupping of the disc. Increased intraocular pressure can cause cupping, which is an indentation of the optical disc. As an increase in optic nerve cupping over time, asymmetry in the degree of optic nerve cupping between the two eyes can be a sign of glaucoma.

  • Perimetry

An ophthalmologist performs a visual field test to assess the patient’s peripheral (side) vision. The patient looks straight ahead while the doctor places a light spot in various locations around the edge of their sight. It aids in the creation of a map of what the person can see.

  • Gonioscopy

The eyes get numbed with anesthetic drops before a particular contact lens with mirrors gets placed on the eyes’ surface. The mirrors allow the doctor to see the inside of the eye from various angles. The goal of this test is to look at the eye’s drainage angle and drainage area. The doctor can use this procedure to determine whether the drainage angle is open or narrow. They can also look for any other abnormalities, like increased pigment in the drainage angle or any long-standing damage to the drainage angle from prior inflammation or injury.

  • Pachymetry

Pachymetry is a method of measuring the thickness of the cornea. After numbing your eyes with anesthetic eye drops, the doctor uses the pachymeter tip to touch the cornea (front surface of the eye). The measurement of intraocular pressure has been shown in studies to be affected by corneal thickness. Thicker corneas may give falsely high readings, while thinner corneas may give falsely low interpretations.

  • Visual Field Testing

The visual field testing method is another diagnostic tool to detect glaucoma. It maps the visual fields to identify any early or late signs of glaucomatous optic nerve damage. Visual fields get measured by a computer one eye at a time to detect and track glaucoma. One eye is covered, and the patient rests their chin in a bowl-like device. Lights of varying intensity and size get projected at random around the inside of the bowl. When light is detected, the patient presses a button. This diagnostic procedure generates a computerized map of the visual field, highlighting the areas where each eye can and cannot see.

Read More: What Are The Causes Of Glaucoma?

Glaucoma Treatment

You cannot reverse the effects of glaucoma. However, proper treatment and regular checkups can help the doctor slow or prevent vision loss, especially if the disease gets detected early. Glaucoma gets treated by lowering your intraocular pressure (intraocular pressure). Your treatment options may include prescription eye drops, oral medications, laser treatment, surgery, or a combination of any of these methods.

Because glaucoma causes irreversible vision loss, the ultimate goal of all of these treatment methods is to prevent vision loss. The good news is that glaucoma management can be effective if the disease gets diagnosed and treated early, and appropriate treatment ensures that no further sight loss due to this eye disease occurs.

  • Eyedrops

Prescription eye drops get frequently used to begin glaucoma treatment. These can help reduce eye pressure by improving the way fluid drains from your eye or decreasing the amount of fluid your eye produces. Depending on how low your eye pressure needs to be, you may require more than one of the eyedrops.

Your eye doctor may prescribe eyedrop medications. These medicines could include prostaglandins, beta-blockers, or alpha-adrenergic agonists. Or other medications like carbonic anhydrase inhibitors, rho kinase inhibitors, miotic or cholinergic. Because some of the eyedrop medication gets absorbed into your bloodstream, you might experience some unrelated side effects on your eyes.

  • Oral Medication

If eyedrops alone are ineffective in lowering your eye pressure, your doctor may prescribe an oral medication, usually a carbonic anhydrase inhibitor. Frequent urination, tingling in the fingers and toes, depression, stomach upset, and kidney stones are all possible side effects.

  • Laser Surgery

If you have open-angle glaucoma, you may be able to benefit from laser trabeculoplasty. It gets completed in your doctor’s office. Your ophthalmologist will use a tiny laser beam to open clogged channels in the trabecular meshwork. It may take a few weeks for the full impact of this procedure to be felt. While the laser can supplement the use of eye drops, it cannot completely replace them. The effects of laser treatments vary, but they can last for up to five years. Some laser treatments are also reversible.

  • Glaucoma Surgery

Another option for lowering eye pressure is surgery. It is more invasive, but it achieves better eye pressure control more quickly than drops or lasers. Although surgery can help slow vision loss, it cannot restore lost vision or cure glaucoma. There are many different types of glaucoma surgeries, and your eye doctor may recommend one over another depending on the specific type and severity of your glaucoma.

You’ll need to see your doctor for follow-up exams after your procedure. Additionally, if your eye pressure begins to rise or other changes occur in your eye, you may need to undergo additional procedures.

Conclusion

Successful glaucoma treatment requires collaboration between you and your doctor. Your glaucoma treatment will get prescribed by your ophthalmologist. It is your responsibility to use your eye drops according to your doctor’s instructions. Once you start taking glaucoma medications, your ophthalmologist will want to see you regularly. You should see your ophthalmologist about every 3–6 months. This can, however, vary depending on your treatment requirements.

While there is no cure for glaucoma, treatments can control eye pressure and prevent vision loss. Eye exams can detect the disease early and help you keep your sight. If you are at high risk for glaucoma, ask your eye doctor how frequently you should get screened. If you have glaucoma, you must use daily eye drops as directed. You can also inquire with your provider about laser treatments and surgical procedures. You can prevent glaucoma from worsening and causing irreversible vision loss or blindness if you take proper care of it.

Remember only to reach out to the most advanced eye-care hospital for your glaucoma problem if you have other health issues or even otherwise. The experts at Dada Laser Eye Institute will guide you through the entire process. The doctors explain the risks involved and share their knowledge about glaucoma before and after your treatment.

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