Common FAQs about Glaucoma
- drgunjandeshpande
- Dec 31, 2022
- 4 min read
Updated: Feb 10, 2025
Glaucoma is a disease marked by gradual loss of vision. However, unlike other ocular illnesses, the patient does not perceive the gradual diminution of vision which generally tends to occur over months and years. Let me share some FAQs asked by my patients. For more details, please feel free to contact me.
Let us begin:
1. What is Glaucoma?
To begin with, our human eye is akin to a camera. Just like a camera clicks photographs, the human eye catches images. What is in that images, has to be analysed by the brain, to be precise the occipital cortex which is situated at the backside of the skull. The optic nerve acts as a conduit which sends signals from the eye to the brain for analyses and we are able to see.
Means for good vision, the entire system must be healthy and work properly; the eyes, the optic nerve and the brain.
Glaucoma is a group of eye conditions that can damage the optic nerve, leading to permanent visual loss and blindness. Once this nerve gets damaged, there is no replacement. There are no mediciens or surgeries that can enhance its ability again. Hence identification and treatment of glaucoma becomes essential.
Glaucoma is often called the 'silent thief of sight' because it often has no symptoms in the early stages, and vision loss may occur gradually over time. Patients may perceive a peripheral visual loss in very advanced stages of the disease.
2. What causes glaucoma?
Again let us understand with a simple example. The human eye is also akin to a balloon. To keep the balloon inflated and in a good shape, it needs to be inflated either using air or water.
Similarly, the eye needs to maintain its shape. A liquid called, aqueous humour is secreted inside the eye which exerts pressure and sustains its spherical contour.
Any condition which increases the pressure within the eye can cause damage to the optic nerve by various mechanisms.
However, there are also other factors that may contribute to the development of glaucoma, including genetics, age, systemic diseases like diabetes and hypertension, and steroid use.
3. How is glaucoma diagnosed?
Glaucoma is typically diagnosed through a comprehensive eye exam. Your doctor will evaluate your vision with spectacles, measure the pressure in your eye, and examine the optic nerve and retina after instilling dilating eyedrops.
If you are at risk for glaucoma, your doctor will take you for further evaluation depending on the severity of the risk.
A special examination of the angles of your anterior chamber of the eye (through which the aqueous drains outside), that is the front portion of the eye is carried out using a special lens called gonioscopy. This helps in understanding the cause for glaucoma and subsequently has a bearing on the management.
Glaucoma can be evaluated for the structural loss and functional loss. The latter is checked by visual perimetry. It checks your peripheral vision. You may need an OCT scan and a fundus photograph for studying structural loss in detail.
Pachymetry is also required for measuring the central corneal thickness. This is important because the thicker the corneal thickness, more is the measured intraocular pressure and vice versa.
After gathering data from all the tests above, your doctor will be able to assess your risk or disease severity and then guide you through your disease well.
4. How is glaucoma treated?
The treatment for glaucoma may include medications (such as eye drops or tablets), lasers, or surgery.
As of today, intraocular pressure is the only modifiable risk factor. Glaucoma treatment aims to lower intraocular pressure to prevent further optic nerve damage, as vision loss from glaucoma is irreversible.
The first line of treatment usually involves medicated eye drops, which either reduce aqueous humour production or enhance its drainage. If medications alone are insufficient, laser procedures such as selective laser trabeculoplasty (SLT) for open-angle glaucoma or laser iridotomy for angle-closure glaucoma can help regulate eye pressure.
In more advanced or refractory cases, surgical options may be necessary. Trabeculectomy is a common procedure that creates a new drainage pathway for aqueous humour, while minimally invasive glaucoma surgery (MIGS) offers a safer, less invasive alternative for select patients. Glaucoma drainage devices, such as Ahmed or Baerveldt implants, are used in severe or complex cases, especially when prior surgeries have failed. These devices help control IOP by diverting aqueous humor to an external reservoir, reducing pressure more effectively in refractory glaucoma.
Since glaucoma is a lifelong condition, regular follow-ups and strict adherence to treatment are crucial for preserving vision. The goal is to lower the pressure inside the eye and prevent further damage to the optic nerve.
5. Can glaucoma be prevented?
Glaucoma cannot be entirely prevented, but early detection and proactive management can significantly reduce the risk of vision loss. Since glaucoma often progresses silently without noticeable symptoms in its early stages, regular comprehensive eye exams are essential, especially for individuals at higher risk, such as those with a family history of glaucoma, high myopia, diabetes, snoring or long-term steroid use. Lifestyle factors, such as maintaining a healthy diet, regular exercise, and avoiding smoking, may contribute to overall eye health, but they do not replace the need for routine screening. While there is no guaranteed way to prevent glaucoma, early diagnosis and timely intervention with medications, laser treatments, or surgery can help preserve vision and prevent severe damage.
6. Can glaucoma be cured?
Glaucoma cannot be cured, as any vision loss caused by the disease is irreversible. However, with early detection and proper treatment, its progression can be controlled to preserve remaining vision. Current treatments, including medicated eye drops, laser procedures, and surgical interventions, aim to lower intraocular pressure (IOP) and prevent further damage to the optic nerve. While these treatments are effective in managing the condition, they do not restore lost vision or eliminate the disease. Since glaucoma is a lifelong condition, ongoing monitoring and adherence to treatment are essential to maintaining vision and quality of life.
If you have any additional questions about glaucoma, it is essential to discuss them with your doctor. They can provide you with more information and help you understand your individual situation.
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