Glaucoma Day -- what to expect when you are diagnosed with Glaucoma

Our expert Dr Prakash Nayak talks about the various treatment options for glaucoma.

My father is suffering from very poor vision due to glaucoma and his condition has degraded very rapidly over a year. Please suggest the treatment method for the same. Could you please tell me how much it would cost? I will also need accommodation. Please help me out.

Answered by Dr Prakash Nayak, Navi Mumbai Eye Clinic, Vashi

Glaucoma is a chronic condition which reduces one s vision over period of time. Your father will need an initial assessment to find out the severity of the disease, and based on the evaluation, a treatment plan can be charted out.

Treatment of glaucoma is aimed at preventing further damage to the nerve in the eyes. unfortunately none of the treatment options can recover the loss glaucoma causes. Treatment of glaucoma involves eye drops, tablets, laser procedure(s), eye operation(s) or a combination of methods. Since the whole purpose of treatment is to keep the eye pressure under control to prevent further loss of vision, one method doesn t supersede the other, e.g. surgery for glaucoma may not necessarily score over the eye drops and none of them can cure the disease. Each treatment modality has its own pros and cons.

The anti-glaucoma eye drops mainly reduce the secretion of eye fluid and thereby reduce the eye pressure. Eye drops may cause a burning or stinging sensation upon application. This is often due to the antibacterial agent present in the drop solution and not due to the drug itself. While it can be uncomfortable, the discomfort lasts for only a few seconds. More importantly it is important that the patient take his/her medication exactly as it is prescribed in order to control their eye pressure effectively. For example, drops which are prescribed two times a day usually have'duration of action' of twelve hours. By taking these drops two times spaced through your waking hours, e.g. at 7 am and 7 pm (with maximum 15-30 minutes on either side) you ensure that you are covered by the drug's effectiveness for a full 24-hour period. Since eye drops are absorbed into the bloodstream, it is important that you tell your doctor about other diseases you might be suffering from and all other medications you are currently taking. Ask your doctor if the medications you are taking together are safe. To minimize absorption into the bloodstream and maximize the amount of drug absorbed into the eye, close your eyes for one to two minutes after administering your drops and press lightly against the nasal corner of your eyelids to close the tear duct that drains into the nose. The eye drops may cause a significant alteration in your life style. But it is very important to not to miss even a single dose of any medication otherwise the eye pressure can fluctuate between the drop applications and continue to damage the eye nerve.

Sometimes, drops are not enough to control the eye pressure. In that case, oral medications may be prescribed in addition to the drops. They do have more side effects compared to the eye drops. Therefore, they are usually prescribed for a short period to control the eye pressure.

Laser procedures are advised in certain types of glaucoma. The most common laser procedure performed for the so called angle-closure glaucoma is called laser iridotomy. This procedure takes between one and three minutes, is painless, and is performed on outpatient basis. The laser beam (a high energy light beam) is directed in the eye to permit the eye fluid to drain more easily. You can resume normal activities in a short time following the procedure. Your doctor will check your eye pressure one hour later. Your doctor will also determine which anti-glaucoma medications are necessary for you after the laser. The possible complications of the laser procedure are minimal and rare.

The most common anti-glaucoma operation is called trabeculectomy. In this procedure, the surgeon removes a small section of the eye wall to facilitate drainage of the eye fluid. This procedure is usually done after giving anaesthetic injection around the eye on an outpatient basis. The doctor will see you on the day after the operation to check your vision and eye pressure. Although trabeculectomy is a relatively safe surgery, complications do occur, therefore, the surgery is advised judiciously. After trabeculectomy, most patients are able to discontinue all anti-glaucoma medications. A few patients may require additional surgery.

As for the cost, eye drops should cost you about a few hundred rupees per month, whereas conventional glaucoma surgery will cost about 15,000 rupees. In your father s case his previous medical history is also essential, so it would be prudent to preserve all his previous medical records. These records will be useful to the treating eye surgeon for deciding the best line of treatment for your father.

If you are travelling to meet your doctor and require accommodation, there are a number of places you can decide to live while his treatment is being carried out. If renting out an apartment or living in a hotel is too expensive for you; you can approach businesses like Surgerica for help.

Read more about causes, symptoms, diagnosis and treatment of glaucoma.

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• Glaucoma How you can prevent blindness with regular checkups
• Glaucoma causes, symptoms, diagnosis and treatment
• Glaucoma and other eye diseases on the rise, say experts

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