Q. What is Glaucoma ?
A. Glaucoma, Kala Motia or Neela Motia is a condition caused by an increase in the pressure in the eyeball. Normal eyes contain a watery fluid that circulates freely inside them. They can maintain their shape and function only if the pressure inside the eyes is within the ‘normal’ limits. If, for any reason, the small tubes that allow the fluid to drain away are blocked, the pressure rises. This may damage the important parts that are responsible for the normal functioning of the eye.
Q. oes Glaucoma occurs only after the age of 35?
A. No, it can also occur earlier, though it is more common after the age of 35. Glaucoma can be divided into ‘congenital’ and ‘acquired’. Acquired Glaucoma may further be divided into (i) the Primary Glaucoma, in which the cause for the defective drainage is not known, and (ii) Secondary Glaucoma, in which the cause for such an obstruction is known. In infants and children the disease may appear due to Congenital (birth) defects, at the angle of the anterior chamber. Secondary glaucoma can be due to acute or chronic inflammation of the iris, accidental injury to the eye, or metabolic disturbances such as Diabetes.
Q. hat happens to the eye if the pressure increases?
A. If the pressure in the eye is high, the eye become harder. Just as in an inflated football, the bladder can get too hard from too much pressure; this high pressure will damage the sensitive parts of the eyeball - such as the optic nerve. The optic nerve fibres get degenerated and the disc shows whiteness and deep cupping. A doctor can diagnose this by just looking into the eyes. In the early stages the patient can see things normally when looking straight, but the peripheral vision is much reduced. Normally a patient can see upto 95 degrees on the outer side, 65 degrees above, 65 degrees on the inner side and 75 degrees in the lower portion. But, with Glaucoma, the limits of the field are reduced. This is the reason why the patient cannot see well in the evening and often stumbles against objects. The defects can be detected by a competent eye doctor much before they can be appreciated by the patient.
Q. hat are the early symptoms of Glaucoma?
A. A dull pain around the eye, especially after being in the dark - such as after seeing a motion picture.
ν Seeing coloured rings around a light, especially in the early morning or at night.
ν Blurring of vision, which clears up after a while.
ν Headache.
ν Night-blindness. The patient takes a longer time to get used to dimly lit rooms.
ν Loss of side vision.
ν Glasses do not seem to help.
ν Frequent changes of glasses are needed for reading and near sight.
Chronic Glaucoma advances slowly and may practically be without any symptoms. A patient may only seek medical advice only at a stage when the disease has damaged the structures irreparably. One can lose sight due to Glaucoma without knowing it.
Q. hat are the differences between Glaucoma & Cataract?
A. These two conditions are quite different and are often confused. Cataract too causes loss of vision, but it is due to clouding of the lens of the eye, which interferes with the passage of light into the eye. This confusion is mainly because both these conditions set in after the age of 35 years.
Q. oes Glaucoma worsen by ‘using’ the eyes?
A. No, if you are being looked after by a qualified eye doctor, you may use the eyes for reading, sewing, playing cards, seeing movies etc.
Q. ow is Glaucoma treated?
A. If the case is being looked after by a qualified doctor, it is possible to treat the disease and prevent the blindness. It is treated by medicine if the disease is detected early. The purpose of this treatment is to decrease the formation of the water (aqueous) in the eye and make the drainage channels more efficient. If the medical treatment fails, or if the disease is more advanced, an operation can be performed to relieve the tension. The aim of the operation is to create an artificial channel for the drainage of water - to compensate for the blockage of the tubes.
It is desirable that the patients suffering from Glaucoma avoid too much coffee or tea. They should drink water in small quantities, otherwise the pressure inside the eye can go up. In case you have any of the above symptoms, consult your eye doctor without any delay.
Dr. R.C. Gupta, Professor & Head, Department of Ophthalmology
Chief - Oculoplastics & Orbit Services,
GSVM Medical College, Kanpur
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