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Raised Eye Pressures Take A Toll

Mrs. Zubeida Shaikh*, a 60 years old lady came with complaints of severe pain, redness, and watering in her left eye associated with nausea and headache . She had a history of decreased vision in her left eye. When she was examined in detail, her visual acuity was found to be 6/9 in the right eye and 6/36 in the left. (This means that she could see at 6 metres what a person with normal vision can see at 9 and 36 metres respectively!)

Detailed examination with a Slit lamp revealed cataract in the right eye. The left eye showed that her conjunctiva (the transparent outermost layer) was congested and cornea (the clear outer dome of the eye) slightly hazy. The front portion (or Anterior Chamber) had become shallow, pupil (the hole in the centre of the coloured part of the eye) was oval in shape and fixed, while the lens showed early cataract. Mrs Shaikh’s pressures were checked in both eyes and found to be 20 and 44 mm Hg (Normally the pressure ranges between 8 – 21). Gonioscopy (a test to study the angle where the iris meets the cornea) showed occludable angles in the right eye and closed angles in the left. Hence a diagnosis of Right Eye angle closure suspect and Light Eye Acute angle closure glaucoma was made.

Glaucoma is a condition where there is damage to the optic nerve usually due to raised eye pressure. There are two types of glaucoma depending on whether the aforementioned angle is open or closed (called open angle glaucoma and angle closure glaucoma).

The Glaucoma Specialist at Advanced Eye Hospital who treated Mrs Shaikh, started the patient on medications (oral acetazolamide and iv mannitol). Eye Pressure was checked afterwards and found to be 16 and 24 mm Hg.

Mrs Shaikh was then advised to undergo a surgery called Peripheral Iridotomy in both her eyes. After surgery, Mrs Shaikh’s eye pressures came down to 14 and 16 mm Hg. The patient was started on anti-glaucoma medications and was advised to follow up after 1 week. After a week Mrs Shaikh was delighted to see that her visual acuity in the left eye had improved to 6/18. Slit Lamp Examination showed a clear cornea, and eye pressures of 14 and 16 mm Hg respectively. Dilated fundus examination revealed a cup: disc ratio of 0.5:1 and 0.9:1 in the right and left eyes. (The lower this ratio is, the better). While her field of vision had unfortunately reduced to an advanced stage in the left eye, that in her right was thankfully normal.

Take Home Message

Glaucoma is the second leading cause of blindness.

Some of the damage is irreparable if not detected in time.

* name changed to protect privacy

About Advanced Eye Hospital and Institute:

Advanced Eye Hospital and Institute (AEHI) in Sanpada is one of the best eye hospitals in Navi Mumbai. Out of the 10 super eye specialists, it has one of the best glaucoma doctor in Navi Mumbai who are trained from prestigious Institutes of India. Best eye specialist for glaucoma at AEHI frequently treat patients with high eye pressure with Peripheral Iridotomy or other suitable glaucoma surgery according to detailed eye check-up.