Glaucoma ( Kala Motia) – What is it ? What questions should I ask my doctor ?
• Just as there is blood pressure, there is an entity called as eye pressure. Its normal value is ≤ 21mm Hg.
• A person having damage to his/her optic nerve (the nerve which transmits signals from eye to the brain) due to the eye pressure is said to have glaucoma. This mostly occurs when the pressure goes above 21mm Hg.
• Adult glaucoma generally occurs in patients over 50 years. The chances of glaucoma increase if there is a family history of glaucoma.
• Adult glaucoma’s can be broadly classified into –
Angle closure type
In this type the intra-ocular pressure rises because there is obstruction to the normal outflow of intraocular fluids.
Open angle type
In this type there is no obstruction but as such the intra-ocular pressure is high.
• What are the symptoms of glaucoma ?
The open angle type of glaucoma is generally asymptomatic. It may be diagnosed during a routine eye examination. Sometimes it can be a cause of headache or vague eye pain. A frequent change in power of near glasses may be a symptom of glaucoma. Loss of central vision is a very late manifestation of glaucoma.
A patient with an acute attack of the closed angle type of glaucoma would have a painful red eye. The pain may be severe enough to even induce vomiting and headache. There is also some fall in vision.
Some glaucomas may lead to a sensation of coloured halos around lights. Although this may also be a symptom of cataract, glaucoma must be ruled out.
• What should I keep in mind if the doctor has diagnosed me as having glaucoma ?
Firstly, it needs to be determined whether your glaucoma is of the open angle type or the closed angle type as the closed angle type generally requires LASER treatment while the open angle type requires medication/surgery.
Secondly, you need to know how much damage has already taken place to your optic nerve. Remember that our aim of treatment is mainly to prevent further damage to your optic nerve. For this various tests are available.
To date the most widely used and most standardized test is a Humphrey visual field analysis. This test might need to be repeated every 3-4 months. This is essential as only a serial follow up can determine the exact amount of damage and whether your treatment is having a beneficial effect or not.
Thirdly, your doctor needs to determine a target intra-ocular pressure for your eye. This is the pressure your doctor assumes to be safe for your eye, i.e. at this pressure there would be no further damage to your optic nerve. This is the pressure the doctor would be aiming to achieve with treatment.
Finally, we have to attain this pressure. In most cases this is tried first by medical therapy (eye drops). If this fails then surgery has to be considered. LASER is generally done for cases with closed angle type of glaucoma.
Glaucoma is a blinding disorder.
If treated properly visual loss in glaucoma can be slowed down drastically in most cases.
However, in most cases it might require life long therapy.
So understand your disease and ask your doctor the right questions to achieve proper treatment.