What is Glaucoma?
One of the most common causes for irreversible visual loss is glaucoma.
Glaucoma is damage to the nerve fiber layer of the retina that is typically caused by an
elevation in the intraocular pressure. It can go undetected until extreme visual loss has taken
place. People at risk for glaucoma include those with a family history of glaucoma, diabetics, those with
hypertension, individuals of African-American decent, and those of increasing age. In general, most
glaucomas are painless and asymptomatic. The visual loss that initially occurs is in the periphery of the
visual field, so that most people do not even notice the visual loss. As glaucoma progresses, and if left
untreated, it can affect the central vision in an irreversible fashion. Glaucoma is diagnosed on a routine
screening eye examination. The initial treatment for glaucoma is the use of eyedrops in order to reduce the
intraocular pressure. If eyedrops fail, then laser or even surgical repair is necessary. That's why it is crucial
for an individual to undergo an annual eye examination, especially if there is a risk factor for such a blinding
What kind of treatment do we offer?
The Heidelberg Retina Tomograph or HRT is the finest techinique in the
early detection, evaluation and to check progression of Glaucoma. It is a
confocal scanning laser imaging device that obtains three-dimensional
images of the optic nerve head and retina in the posterior segment,
checking the height changes or differences of the optic nerve head. There
is now good evidence that the HRT can diagnose glaucoma 5 years before
changes become evident by any other technique. The HRT is now the gold
standard for imaging the optic nerve. The Mehta International Eye Institute
uses the Heidelberg Retina Tomograph in its continuous effort to provide
quality care to its patients. The test is usually repeated thrice a year, and helps the physician assess if
changes are occurring in the nerve fiber layer or the optic nerve head. These changes almost always occur
prior to any visual symptoms the patient.
The Humphrey Compurerized Field analyzer
An instrument which evaluates what you can see with your “fields” of from the
periphery of your eye while keeping the eye fizxated in the middle. It evaluates
the extent of loss. In gluacoma the fileds progressively decrease till only a
central island is left, which if untreted, extinguishes leading to blindness. The
Humphrey Analyzer is the Gold standard all over the world. Fields are
normally done twice a year.
Intraocular pressure evaluation
Non Contact Pneumotonometer: Acts as an analyzing tool and excellent as a survey
instrument. Reasonably accurate when kept properly gradted. The Topcon is perhaps
the most sensitive of this genere.
What are the symptoms?
Symptoms are: (a) Frequent change of glasses (none of which is satisfactory)
(b) Difficulty in dark adaptation. (c) Bumping into things at unfamiliar places.
(d) Blurred or foggy vision. (e) Coloured halos (rainbow coloured rings) around
These are some examples of the progression of glaucoma:
This is an example of normal vision.
This is also an example of how someone sees during the
beginning stages of open-angle glaucoma. Because there
are no symptoms initially, regular eye examinations are very
Early symptoms may include a gradual and often
imperceptable failing of peripheral (side) vision.
As the disease progresses, the center of vision may
still be clear, however peripheral vision begins to fail.
During the advanced stages of glaucoma, only a small
central area of vision remains. If the entire optic nerve
is destroyed, then total blindness will result.
Goldman Applanation Slit Lamp Biomicroscope mounted
Exceptionally accurate but requires steady fixation. Can identify pressure
accurately even in post operative and highly myopic eyes.
When the surface is grossly irregular or as a verification device the Schiotz tonometry is an
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