Glaucoma Treatment in India: Understanding the Silent Thief of Sight

Glaucoma, a significant concern in the field of Ophthalmology, is a category of eye diseases that damage the optic nerve, essential for vision. This damage may result from IOP or elevated intraocular pressure, causing progressive and irreversible vision loss. It is an eye condition specified by damage to the optic nerve, transmitting visual information from the eye to the brain, typically associated with increased intraocular pressure. Glaucoma can also occur with low or normal intraocular pressure. Glaucoma surgery symptoms are undiscoverable in its early stages, making regular eye exams vital for early detection.

As a leading cause of blindness worldwide, understanding glaucoma's mechanisms, types, symptoms, risk factors, and glaucom treatment in India options is crucial for management and prevention in the realm of Ophthalmology.

Is Glaucoma Hereditary?

Yes, glaucoma might be hereditary as several forms of glaucoma have strong genetic components, meaning that a family history of the condition significantly increases the risk of developing it.

Just for example, POAG, the common form of glaucoma, mostly runs in many families. Some specific genetic mutations like in the MYOC gene, have been linked to POAG. Likewise, congenital glaucoma appears at birth or during early childhood and is frequently associated with genetic mutations, especially in the CYP1B1 gene.

These genetic factors may impair the development and function of the eye’s drainage system and lead to increased intraocular pressure and optic nerve damage. Normal-tension glaucoma too shows a hereditary pattern. Family history is a significant risk factor. Advances in genetic research are continuously improving our understanding of the hereditary aspects of glaucoma which leads to better risk assessment and personalized treatment strategies.

Note: Individuals with close relatives who have glaucoma are advised to undergo regular eye examinations to detect early signs of the disease.

Various Types of Glaucoma

There are various types of glaucoma including:

Primary Open-Angle Glaucoma (POAG)

It is one of the most common forms, contributing to about 70% of glaucoma cases. POAG occurs when the eye's drainage angle, where the iris meets the cornea, gets blocked, increasing intraocular pressure. The outflow of fluid is impaired, causing a gradual increase in pressure and eventually leading to optic nerve damage. Its symptoms are often unnoticed for years until significant vision loss occurs. The types of POAG may include:

• Exfoliative Glaucoma
• Juvenile Open Angle Glaucoma
• Sporadic Open Angle Glaucoma
• Familial Open Angle Glaucoma

Angle-Closure Glaucoma

It is also called closed-angle or narrow-angle glaucoma and is often acute (comes on suddenly). It occurs when the eye’s drainage angle becomes entirely blocked, stopping the aqueous humor from draining out. The narrow-angle glaucoma may be acute or chronic and requires immediate treatment. the symptoms may include headache, vomiting, severe eye pain, nausea, seeing halos around lights, and blurred vision.

Normal-Tension Glaucoma

Other names for this particular glaucoma are normal-pressure glaucoma or low-pressure glaucoma. It may even occur with normal-range intraocular pressure. The exact cause of this type is not well understood but may involve poor blood flow to the optic nerve or factors unrelated to pressure. Its symptoms are mostly similar to open-angle glaucoma and possible vision loss. The types of normal-tension glaucoma are:

• Acute Angle Closure Glaucoma
• Chronic
• Subacute
• Intermittent
• Creeping
• Plateau Iris Syndrome
• Nanophthalmos
• Microphthalmos

Secondary Glaucoma

The type of glaucoma arises due to some underlying medical conditions or external factors. It is a complication linked to other health issues, unlike primary glaucoma which occurs without apparent secondary cause. Some types of secondary glaucoma are:

• Neovascular Glaucoma
• Pigmentary Glaucoma
• Steroid-Induced Glaucoma
• Traumatic Glaucoma
• Uveitic Glaucoma

Congenital Glaucoma

The type of glaucoma also known as pediatric or infantile glaucoma is a rare but serious condition present at birth or developing within the first few years of life. it may result from abnormal development of the eye’s drainage system before birth, leading to increased intraocular pressure (IOP) and following optic nerve damage. Its early diagnosis treatment is crucial to prevent blindness. Its common symptoms may include cloudy cornea, excessive tearing, and enlarged eyes.

Few Symptoms and Causes of Glaucoma

Glaucoma is also known as the “silent thief of sight” as it develops slowly without any major noticeable glaucoma symptoms, and vision changes can happen gradually making it easy for symptoms to be missed. It is very important to have a routine eye exam to detect it in its early stages as many people with open-angle glaucoma don’t have any noticeable symptoms. However, as the disease progresses, the following symptoms may appear:

• Blurry vision especially in acute angle-closure glaucoma
• Halos around lights noticeable in acute cases
• Tunnel vision a narrowing of the visual field
• Severe eye pain and redness
• Peripheral vision loss
• Nausea and vomiting

It can happen without any particular cause, but various factors may affect it. The most common and important factors in intraocular eye pressure. Our eyes produce a fluid called aqueous humor that provides nourishment to the eyes. This fluid leaves through the drainage vessels near the iris and cornea.

The resistance is increased in the drainage vessels with glaucoma. When this fluid has nowhere to go, it builds up in your eye. This excess fluid puts pressure on the eye and might damage the optic nerve of the eye leading to glaucoma.

Note: these are some of the very common glaucoma symptoms that are mentioned above and might be associated with any other problem. You are advised to consult with the surgeons and doctors in case you notice these symptoms

Some Glaucoma Risk Factors

It can affect anyone and the risk keeps increasing with age. It can damage vision before you notice any symptoms. Some of the glaucoma risk factor may include:

• Family history of glaucoma
• Age over 55
• Immense interior eye strain, also called intraocular pressure
• Corneas that are thin in the center
• Extreme near-sightedness or far-sightedness
• Various medical conditions, like diabetes, high blood pressure, migraines, and sickle cell anemia
• Eye injury or some types of eye surgery
• Consuming corticosteroid medicines, especially eye drops for a long time

Tests and Diagnosis for Glaucoma

In many cases, patients don’t know that they have glaucoma. Regular eye exams are considered important to catch any eye problem or glaucoma. Eye exams can evaluate optic health and vision loss. To check if someone has glaucoma, an eye doctor might perform one or more painless tests mentioned below:

• Gonioscopy is used to examine the angle where the iris and cornea meet.
• A dilated eye exam is used to widen pupils to get a view of the optic nerve at the back of the eyes.
• Ocular pressure test or tonometry is used to measure eye pressure.
• Slit-lamp exam is used to examine the inside of the eye with a special microscope named slit lamp.
• Visual field test or perimetry is used to check the changes in peripheral vision, the ability to see things off the side.
• Visual acuity tests or eye charts are used to check for vision loss.
• Pachymetry is used to measure corneal thickness.
• Optical coherence tomography (OCT) is used to look for changes in the optic nerve that might indicate glaucoma.

Some of the Treatment Options for Glaucoma

Medications

Various glaucoma eye drops are prescribed by the doctor for the treatment. some of the drops decrease fluids, whereas some help in increasing drainage to improve eye pressure. As glaucoma is a lifetime disease, the patient may need to use eye drops for the rest of their lives.

Laser Therapies

Many eye doctors use a strong beam of light or laser to improve fluid drainage from the eye. The doctor may suggest laser therapy instead of glaucoma eye drops. However, laser therapy might not guarantee the replacement of the use of eye drops completely. Some types of laser treatments for treating glaucoma treatment in India include:

• Laser Iridotomy: it includes creating a small hole in the iris that helps in improving fluid drainage in angle-closure glaucoma.
• Laser Cyclophotocoagulation: It helps in reducing fluid production in the eye.
• Laser Trabeculoplasty: It is used in open-angle glaucoma for enhancing drainage.

Surgical Procedures

Surgery is another glaucoma treatment in India that reduces eye pressure. Glaucoma surgery in India might be more invasive but is proven best to achieve better eye pressure control than any drops or lasers. It can help in slowing down vision loss, yet it cannot restore the lost vision or cure glaucoma. Some of the surgeries may include:

• Tube shunt surgery: In this surgery. A tube is implanted to facilitate fluid drainage.
• Minimally Invasive Glaucoma Surgery (MIGS): This surgery utilizes small incisions to improve fluid drainage with fewer complications. These procedures mostly take less time to perform and have shown fast recovery time.
• Trabeculectomy: this surgery creates a new drainage pathway for fluid.

Glaucoma Treatment in India

India has emerged as a significant chain for glaucoma treatment, leveraging a junction of advanced medical technology, the best glaucoma treatment hospitals in India, and a cadre of highly skilled ophthalmologists. This ocular malady is characterized by increasing intraocular pressure that can lead to vision impairment by adapting intervention.

The nation’s medical organizations and super-specialty hospitals are equipped with modern diagnostic and therapeutic apparatus. These facilities employ advanced techniques such as MIGS and laser trabeculoplasty and forestall the progression of optic nerve damage. Some of the best glaucoma treatment hospitals in India are:

• Artemis Hospital, Gurugram
• Indraprastha Apollo Hospital, New Delhi
• Medanta The Medicity, Gurugram
• Max Super Specialist Hospital, Delhi
• Fortis Hospital, New Delhi

Indian Ophthalmologist brings a wealth of expertise to the glaucoma treatment regimen. The surgeon's proficiency is complemented by a deep understanding of diverse forms of glaucoma, allowing for personalized treatment protocols. Some of the glaucoma specialists in India include:

• Dr. Sameer Kaushal, Artemis Hospital, Gurugram
• Dr. Sanjay Dhwan, Max Super Speciality Hospital, New Delhi
• Dr. Nidhi Verma, Medanta The Medicity, Gurugram
• Dr. Vishakha Kapoor, Medanta The Medicity, Gurugram
• Dr. Aditi Krishna Agarwal, Fortis Hospital, Gurugram

The low glaucoma surgery cost without compromising quality makes India an attractive destination for both domestic and international patients seeking glaucoma surgery in India. The integration of holistic care, including patient education on the importance of observance of glaucoma surgery and regular follow-ups, compiles the comprehensive approach followed by doctors and hospitals.

Conclusion

Glaucoma is considered a serious eye disease that may lead to vision loss or even blindness, if not treated on time. Understanding Glaucoma symptoms, risk factors, diagnosis, treatments, and causes can help patients take proactive steps to protect their vision. Individuals are advised for regular eye exams and maintenance of a healthy lifestyle may go a long way in preventing glaucoma and prevention from vision loss. Glaucoma in India provides treatments with various range of options, from advanced surgeries to medications with low Glaucoma surgery cost. With a well-built healthcare infrastructure and glaucoma specialists in India, it is considered a popular destination for glaucoma treatment.

Medheal Global helps international patients visiting India for medical care by ensuring a seamless and stress-free experience. We will facilitate communication, treatment planning, logistical support, travel assistance, cultural support, and follow-up care. By providing these services, we hope to ensure international patients have a practical treatment experience in India.