Glaucoma surgery: an overview

The current status of glaucoma care in the world may be summarized as follows: More than half of glaucoma in the community (and more than 90% in developing countries) is undiagnosed, more than 50% of patients with undiagnosed glaucoma have seen an eye care provider in the recent past, more than half of patients taking glaucoma medications do not need them (overtreatment) and 50% of those advised to take medication do not do so.

Of the 1.14 billion people living in India, 260 million are below the country’s poverty level and 193 million live in rural settings. The quality of ophthalmic care differs between urban and rural areas, which results in divergent practice patterns and patients who cannot or do not comply with treatment.

In our clinical practice we have noticed that education level and family support contribute to noncompliance. Near half of the patients on at least one medication, reported one or more problems in using their medication.

If we compare regular vs. irregular follow-up, independent predictors of poor follow-up included lack of formal education, failure to use prescribed glaucoma medications, and belief that follow-up is less important if one uses glaucoma medications and has no noticeable visual changes. The most prevalent barriers to follow-up were belief that there was no problem with one’s eyes and lack of escort to office visits.

We have seen in our clinical practice that numerous generic medications are available but they are not necessarily cheaper than brand-name drugs. The drop size in the bottles of most medications was found to be much larger than necessary.

Our hospital runs Glaucoma Clinics for the special purpose of preserving sight in sight threatening conditions such as glaucoma.

1. The patient receives specialized care provided by our fellowship trained glaucoma specialists
2. Glaucoma needs regular follow-up since the condition can cause asymptomatic and irreversible loss of vision if poorly treated or neglected
3. The effect of your treatment on the eye pressure may not always be constant and needs to be regularly measured by our glaucoma specialist.
4. At the clinic we record images and maintain records of your eye condition for comparison on following visits.

The main treatment for chronic glaucoma aims at reducing the pressure in your eye. Damage already caused by glaucoma cannot be reversed. Eye drops, tablets, laser and surgical operations are used to prevent or slow further damage from occurring. With any type of glaucoma periodic examinations are very important to prevent loss of vision.

Surgery is recommended when your doctor feels that it is safer to operate than to allow optic nerve damage to continue. A new drainage channel is created for the aqueous fluid to leave the eye. Sometimes a tube drains the fluid in very resistant cases.

Glaucoma surgery is done to reduce the intra-ocular pressure inside the eyes as well as restore the health of optic nerve. It could be done by adopting any of the three approaches like – making a flap in the eye to drain the fluid, destroying the tissues forming excessive fluid in the eye or inserting a drainage valve. Surgery cannot restore lost vision but it can control the progression of the disease.

When medications do not achieve the desired results, or have intolerable side effects, your ophthalmologist may suggest surgery. Because, glaucoma can irreversibly worsen without your being aware of it, your treatment may need to be changed from time to time during the periodic examination.

You may also like to read: Glaucoma

About Dr. Rajesh Mishra, Glaucoma specialist

Dr. Rajesh Mishra is accomplished fellowship trained Glaucoma specialist in vashi and is one of the best glaucoma and cataract specialists in Navi Mumbai. He has super speciality training in Glaucoma and Phacoemulsification, from south India based premier eye care institutes (Aravind eye hospital, Eye foundation, Sankara eye hospital).

About Glaucoma clinic, AEHI

Glaucoma clinic at Advanced Eye Hospital and Institute in Navi Mumbai is equipped with one of the best glaucoma clinics in Mumbai. Glaucoma diagnostic facilities, check-up and the operation theaters are state-of-art and equipped with the best diagnostic and surgery machines. Personalized care, infection free modular operation theaters and beautiful ambiance complement the cutting edge eye care offered at AEHI. Besides treating patients from Kharghar, Nerul, Vashi and Panvel, patients from all over western India travel to AEHI for world class glaucoma management.

Glaucoma service at Advanced Eye Hospital and Institute (AEHI), Sanpada near Vashi station in Navi Mumbai is dedicated to the care and treatment of people who have glaucoma. Glaucoma service at offers sophisticated, state-of-the-art diagnostic facilities. AEHI provides a team of fellowship trained Glaucoma specialist, ophthalmologists, diagnostic equipment such as slit lamps, GAT, Gonioscopy, Perimetry, Fundus camera, OCT. We have facilities for advanced laser and surgical procedures to control Glaucoma such as trabeculectomy, tube implants, non-penetrating glaucoma surgeries, surgery for congenital glaucoma and different lasers for glaucoma management.

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