 Hello everyone, my name is Dr. Divya Enraj, I am working as a consultant of thalmologist in Manipal Northside Hospital, Malaysia branch. Today I am here before you to give you a brief information regarding an eye disease called as glaucoma. Most of you are aware of what is glaucoma but still there are people who actually don't know what glaucoma is. So I will be giving a few information about that. Glaucoma is a group of eye disorder which causes irreversible damage to your eye nerve. I repeat the word irreversible because the damage which happens because of glaucoma is not going to come back. Before going to what is glaucoma, I would like to give a brief introduction regarding an intraocular pressure. What is this intraocular pressure? As body is having blood pressure, eye is also having an pressure. What is this pressure? It is caused by a fluid called as aqueous humor. Aqueous humor is a fluid which is there inside the eye which maintains the shape of the eyeball. The production and drainage happens within the eye. Whenever there is imbalance between the production and drainage that is increased production or decreased drainage, the fluid starts accumulating inside the eye and this starts causing pressure on your eye nerve that is the optic nerve. When the fluid starts accumulating within the eye, it causes pressure on your optic nerve. This pressure will compromise the blood flow of the optic nerve and there is damage to optic nerve and this damage will be irreversible in nature. Not only patients with increased ocular pressure but patients with normal ocular pressure also can present with signs and symptoms of glaucoma. Now why is this glaucoma important? There is the second most common cause for blindness worldwide. 90% of the patients in India with glaucoma are still undiagnosed. Why is this? Because lack of awareness. I will come to the awareness part later. Glaucoma, there are various types of glaucoma. There is primary open-angle glaucoma, there is closed-angle glaucoma, there is congenital glaucoma, there is secondary glaucomas and normal tension glaucoma. In primary open-angle glaucoma, there is increased production whereas the drainage is normal. In angle closure glaucoma, there is normal production but reduced drainage. There is something called as congenital glaucoma which is there since birth. There is normal tension glaucoma wherein the pressures in the eye are normal whereas there is damages to optic nerve. Glaucoma is called the sneak thief of sight because it is asymptomatic in the early stages. People will not experience any kind of symptoms like blurred vision or eye pain or headache. You will not find any kind of symptom but the damage would have already started. It is said that 40% of vision loss will happen without the knowledge of the patient. So hence it is asymptomatic. The screening of glaucoma is very very important. By screening, we can detect the glaucoma in early stages. We can give appropriate treatment and we can also prevent the loss of field of vision. So now what are the populations who are supposed to be screened? That is who are the people who are supposed to come and approach us to get glaucoma test done? The first group of people are all people above 40 years of age. Be it male, be it female, they are supposed to get screened for glaucoma. As the age advances, the possibility of getting glaucoma increases and this can happen in any kind of population. The second group of people are those with family history. Family history in the sense if your parents either mother or father are diagnosed with glaucoma or your siblings if they are diagnosed with glaucoma, the probability of you getting glaucoma is again increased. So if you have a family history of glaucoma, you are supposed to come and get it screened. The third group of population, these are those with diabetes, long-term diabetes and hypertension. People with diabetes and hypertension, even they have an increased risk of getting glaucoma. The fourth group of people are, we call them as high myope, that is high power, high negative power. If your spectacles powers are very high, even you guys are prone for glaucoma, you have to come and get yourself checked. The fifth group of population are those on steroid treatment. For example, if you are taking any steroid medications because of bronchial asthma or because of any other connective tissue disorder, if you are on a steroid therapy, then please get yourself checked for glaucoma. And other group of population, that is those who are having an habit of alcohol consumption and smoking, even you guys are also at a risk of getting glaucoma, so please get yourself screened. Now, what are the tests we do to detect whether you have glaucoma or not? The first test will be tonometry, wherein we measure your eye pressures. The normal eye pressures are said to be between 10.5 to 21 mmhg. Anything more than 21, again it's a risky factor for development of glaucoma. The second test what we do is your optic nerve evaluation, that is your eye nerve evaluation. As in the picture, you can see the healthy optic nerve appears almost orange-pink in color. It is healthy in nature, whereas optic nerve damage in glaucoma, there is increased amount of paleness in the optic nerve because of damage to the optic nerves. The third test will be the visual field test, wherein we will be testing your visual field. That is your field of vision, the extent you can see in all the directions, that we will be checking in your visual field test. So any loss which has happened, we can detect it with visual fields. You can see in the pictures, in the right top you have extreme glaucoma, where there is concentric constriction of visual fields. In the top right picture you can see the extreme glaucoma, wherein there is constriction of visual fields all over. Whereas in the normal vision, that will not happen. So if you are finding any tubular vision like this, you are supposed to come and please get yourself checked for glaucoma. Coming to the management part of glaucoma, there are three different types. One is medical therapy, second one is laser management and the third one is surgery. So if any patient for that matter have been detected that they are having glaucoma, the first thing will be a medical therapy. Medical therapy consists of putting eye drops, anti glaucoma medications will be given to you in the form of eye drops and you will have to use it. If medical therapy is not working for you, then there are laser options. There are laser trawacoloplasty, laser iridactomy, wherein we make some space for the drainage of the excess fluid collection. If person is not responding to both adequate medical therapy as well as laser, only in such cases and in advanced cases, we consider surgical management. Trawacolectomy, wherein we create a small hole in the iris so that the excess amount of fluid gets drained out easily. So those people who have already been diagnosed with glaucoma, kindly put your drops properly in the same frequency as described by your doctors. Kindly have a frequent follow up with your doctors and get your visual field tests done annually and those people who have already mentioned, those who are actually falling in the category of risk factors, please get yourself screened. If you find this video useful, if you find the information whatever I have told you is useful, kindly please share it among your friends and family so that it will be beneficial to all because glaucoma can occur to anybody at any point of time. If you are having any doubts regarding this or if you are having any queries or questions you can put in the comment section below. I would try to answer it as fast as possible. Thank you for your kind patience.