Download Glaucoma

DEPARTMENT OF COUNSELLING
Glaucoma
ARAVIND EYE CARE SYSTEM
Aravind Eye Hospital
& Postgraduate Institute of Ophthalmology
What is Glaucoma?
 Glaucoma is a disease of the optic nerve,
caused by an increase in the intra ocular
pressure (pressure inside the eye)
 This is characterised by a gradual
progressive loss of neutrons causing a
progressive constriction of visual fields
 Optic disc cupping
Symptoms
 Patients with glaucoma may not have
any symptoms
Some patients may complain of
 Frequent change of glasses
 Loss of field of vision
Patients with angle closure glaucoma
may complain of recurrent attacks of
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Redness
Pain
Blurred vision
Coloured vision
Headache, vomiting
Types of Glaucoma
1.
Primary Open Angle Glaucoma (POAG):
There is no functional block to the flow of fluid inside the
eye (aqueous humour)
2.
Primary Angle Closure Glaucoma (PACG):
There is a block in the flow of fluid (aqueous humour) in
the eye at the level of the pupil
3.
Congenital Glaucoma:
Occurs from birth and is hereditary. Visual prognosis is
guarded.
These patients usually need multiple medications & surgery
Parents of children with congenital
glaucoma complain of
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Child avoiding light
Increase in the size of the eyes
Squinting of eye
Increase tearing from the eye
4. Secondary Glaucoma:
Can be due to
 Trauma
 Following surgeries of the anterior or
posterior segment
 Following chronic inflammation
 Prolonged use of steroids
 Long standing diabetes, retinal vessel
occlusions
Types of Glaucoma
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Phacomatic Glaucoma
Phacolytic Glaucoma
Pseudo extoliation Glaucoma
Neo vascular Glaucoma
Pigmentary Glaucoma
Aphakia Glaucoma
Pseudo phakia Glaucoma
Cont…..
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Steriod Induced Glaucoma
Traumatic Glaucoma
Low tension Glaucoma
Normal Tension Glaucoma
Ocular hypertensive Glaucoma
Absolute Glaucoma
Jwenile Glaucoma
Investigations
These are important for early
diagnosis of the disease and also in
follow up to prevent out progression
of the disease
Visual Field Testing
 This analyses the field of
vision of the patient
 Ideally should be repeated
every year or once in a --- month to rule our
progression of the disease
 The patient has to
understand and cooperate
with the test for it to be
useful
Central Corneal Thickness
 The intra ocular pressure measured by
applanation can vary with any change the
thickness of the cornea
 So CCT is measured for all patients with
glaucoma
OCT:
This is to diagnose early glaucoma a stage when it
cannot be diagnosed, by routine field test and
involves scanning of the nerve fibre layer around
the optic disc
SWAP:
This is a modified field, test which uses coloured
stimulus
Also help in diagnosis early glaucoma
UBM:
A technique to scan the anterior part of the eye to
rule out structural abnormalities
Role of Counsellor
Counsellor should explain to the
patient why specific investigations
are essential and why they have to
be repeated to rule out progression
of the disease