What is Glaucoma ?

➢ An abnormal increase in the pressure of the eyeball➢ Leading to optic nerve damage➢ Results in progressive, irreversible loss of vision

A Normal Eye vs Glaucoma Eye

NORMAL EYE GLAUCOMA

high pressuredamages optic nerve

Drainage canal blockedToo much fluid stays in the eye

this increases pressure

The Growing Burden of Glaucoma

➢ More than 50% of those with glaucoma world life are undiagnosed➢ Glaucoma is the leading cause of irreversible blindness

2040

Expected to rise to 111.8 million

2016

60MILLIONestimated

2020

76MILLIONestimated

2040

111MILLIONestimated

2020

Anticipated to increase by 18.3% and affect 76

million

2016

Worldwide, 64.3 million individuals aged 40-80 years estimated to have

glaucoma

Glaucoma

Congenital Infantile

Acquired

Primary Secondary

Primary Open Angle Glaucoma

Angle Closure Glaucoma

Types of Glaucoma

Congenital InfantileIt is rare disease, occurs when congenital defect in the angle of the Anterior Chamber obstructs the flow of the Aqueous Humor

➢ Rise in IOP during intrauterine life and child is born with ocular enlargement

➢ Most common glaucoma➢ Incidence increases with age.➢ Aqueous fluid drainage is poor and

pressure builds up in the eye.➢ Leads to damages of the Optic

Nerve➢ Develops gradually with no pain and

its asymptomatic.

Primary Open Angle Glaucoma (POAG)

➢ The eye drainage angle suddenly becomes completely blocked, pressure builds up rapidly

➢ Symptoms : ○ Severe eye pain○ Blurred vision○ Headache

Angle Closure Glaucoma(ACG)

Open-angle Glaucoma

Posterior Chamber

Canal of Schlemm

AnteriorChamber

Pupil

Cornea

Close-angle Glaucoma

Iris

Aqueous Flow

Ciliary Body

Closed Angle

Canal of Schlemm

TrabecularMeshwork

Aqueous Vein

Episcleral Vein

Glaucoma that develops due to other conditions :

Eye Injuries Steroid use

Secondary Glaucoma

Am I at risk for Glaucoma ?➢ Family history of glaucoma➢ Older age above 60 years➢ Diabetes mellitus➢ Short - sightedness➢ Trauma / Injury➢ Prolonged use of topical or systemic corticosteroids

What am I supposed to do to know if I have Glaucoma ?➢ A regular eye check with an Ophthalmologist is essential

○ Slit Lamp Examination○ Goldman Tonometer○ Fundus Photography○ OCT scan○ Visual Field Examination○ Central corneal thickness

Slit Lamp Examination Goldmann Tonometer Fundus Photography

Fundus Image showing Glaucomatous change

Visual Field ExaminationOCT Scan

Normal Eye

Early stage

Vision Loss

Moderate Glaucoma

Advance Glaucoma

Treatment Goal ?

➢ Prevent progressive loss of optic nerve fibers and maintain the visual field

➢ Treat the risk factor that can be altered - Increased IOP

Glaucoma Treatment Options

1. Glaucoma eye drops

➢ Glaucoma eye drops are the first choice of treatment plan to control / lower the IOP

Treatment

2. Laser Peripheral Iridotomy

➢ Laser is used to create a hole in the iris. ➢ This allows aqueous humor to transverse directly from the posterior to

anterior chamber➢ Mostly used for Angle closure Glaucoma

3. Trabeculectomy

➢ Surgical procedure by removing part of the eye’s trabecular meshwork and adjacent structures

Trabeculectomy

Peripheral Iridectomy

Trabeculectomy and Peripheral Iridectomy

Thank You