Kala Moti: A Silent Killer

Glaucoma is a chronic neurodegenerative disease of the optic nerve (the second cranial nerve). It is the most common neurodegenerative disease, affecting about 70 million people worldwide. Glaucoma is the 2nd most common disease causing blindness after cataract, although the speed and degree of vision loss very. Glaucoma blindness is irreversible but preventable 

Can only be treated and not cured

   

However, most people with glaucoma are not diagnosed or treated. In my clinical practice in Kashmir, on a daily basis I come across many cases of glaucoma (both undiagnosed and on treatment). Glaucoma is quite prevalent in our population. Lack of awareness among general masses and lack of awareness about the disease in patients is a matter of concern.

This small write up is only intended to bridge the gap between disease and patient so that we can fight this disease better.

WHAT YOU NEED TO KNOW

What is IOP?

IOP is IntraOcular Pressure. The distribution of IOP within the general population has a range of 11-21 mmhg. Although there is no absolute cut off point, 21mmhg is considered the upper limit of normal and levels above are viewed with suspicion.

What are risk factors for glaucoma?

A) Age: common in older individuals

B) Family history: First degree relatives of patients with glaucoma are at increased risk.

C) Diabetes 

D) Hypertension 

E) Myopia (Patients with glasses having minus power)

F) Retinal diseases (Vein occlusion, Retinal detachment, Retinitis pigmentosa)

G) Patients on Steroid drugs

How to screen & diagnose glaucoma?

A) IOP Measurement (Non contact Tonometry/ Applanation Tonometry)

B) Diurnal variation test: where a patients IOP is monitored throughout the day to see for pressure fluctuations.

C) Clinical Examination & assessment of Optic disc by specialist

D) Visual fields (HVF) test

E) Gonioscopy by a trained specialist

F) If need be, specialised tests like GDx, HRT, OCT disc/RNFL.

After your doctor evaluates you thoroughly, he/she will determine whether to label you as glaucoma patient or not.

In case you are diagnosed with glaucoma, your specialist will set a “Target IOP” for you and start you on anti-GLAUCOMA medications & monitor you periodically.

If your disease is in advanced stage and warrants surgery, your doctor can advise and perform Trabeculectomy+/-ologen implant or a Valve implant.

By acting on time, you ensure safety of your vision. Glaucoma if diagnosed on time can be prevented. Late diagnosis of disease almost always leads to permanent visual disability.

Let us all come together and fight this disease. 

Dr. Shazia is working in ASG eye hospital, Srinagar as a Phaco Cataract and Glaucoma surgeon. 

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