1. Glaucoma Clinical features and management
Dr (Maj) G Premnath
MS (Ophthal)
Clinical fellow- Glaucoma
Asst. Professor
Dept of Ophthalmology
Vertical integration

2. Glaucoma Second leading cause of blindness worldwide.
8% of global blindness is due to glaucoma.
Progresses slowly with few, if any, noticeable symptoms in the early stage.
Glaucoma-related blindness is avoidable only with early detection and treatment.
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

3. Types Open angle Closed angle Congenital Acquired Primary Secondary
Normal-Tension Glaucoma
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

4. Open Vs Closed angle OPEN CLOSED
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

5. Pseudo exfoliation glaucoma
Acute angle closure
Lens induced glaucoma
Pseudo exfoliation glaucoma
Neo vascular glaucoma
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

6. Pathophysiology

10. Signs & Symptoms Typically no early warning signs or symptoms.
Initially PERIPHERAL VISION is lost.
Visual acuity is maintained until late in the disease.
By the time a patient is aware of vision loss, the disease is usually quite advanced.
Vision loss from glaucoma is not reversible with treatment, even with surgery.
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

11. Signs & Symptoms Hazy or blurred vision Coloured halos
Severe eye pain and head ache
Nausea or vomiting
Sudden sight loss
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

14. Visual fields

15. Vision in Advanced Glaucoma
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

16. Who are at risk ?
Everyone is at risk for glaucoma. However, certain groups are at higher risk than others.
Family Members with Glaucoma - increases risk of glaucoma four to nine times.
People above the age of 40 yrs
African Americans - six to eight times more common
Asians
People of Asian descent appear to be at increased risk for angle-closure glaucoma.
Steroid Users- any form (Creams, Inhalers, Tablets etc)
Eye Trauma
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

17. When to test eyes Before age 40, every two to four years
Age 40 to age 54, every one to three years
Age 55 to 64, every one to two years
After age 65, every six to 12 months
Anyone with high risk factors should be tested every year or two after age 35.
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

18. A Comprehensive Glaucoma Exam
The inner eye pressure – Tonometry
Optic nerve head- Ophthalmoscopy (dilated eye exam)
The angle of anterior chamber - Gonioscopy
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

19. Field of vision – Perimetry
Thickness of the cornea - Pachymetry
Regular glaucoma check-ups include two routine eye tests: tonometry and ophthalmoscopy.
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

20. NON-CONTACT TONOMETRY
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

21. PACHYMETRY
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

22. GONIOSCOPY
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

23. FUNDUS PHOTOGRAPHY
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

24. PERIMETRY
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

25. OCT RNFL ANALYSIS
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

26. TREATMENT OPTIONS Medications- Eye drops Prophylactic LASER iridotomy
Filtering surgeries
Implants
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

27. TAKE HOME MESSAGE !
Screening for glaucoma is the only way to detect glaucoma early.
Early detection is important in preventing blindness as treatment is more difficult and less effective in the advanced stages of glaucoma.
Follow-up
GLAUCOMA: NO PAIN, NO SYMPTOMS- SILENT THIEF OF SIGHT

28. THANK YOU!