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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.

GlaucomaOne of the most common causes for irreversible visual loss is glaucoma. Glaucoma isdamage 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 disease

What are the symptoms?
The most common symptoms are:
  • Frequent change of glasses (none of which is satisfactory)
  • Difficulty in dark adaptation
  • Bumping into things at unfamiliar places.
  • Blurred or foggy vision.
  • Coloured halos (rainbow coloured rings) around lights.

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 important.

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.

What kind of treatment do we offer?

Heidelberg Retina Tomograph or HRT

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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 fixated in the middle. It evaluates the extent of loss. In gluacoma the fileds progressively decrease till only a central island is left, which if untreated, 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
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Non ContactPneumotonometer: 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.

Schiotztonometry
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When the surface is grossly irregular or as a verification device the Schiotz tonometry is an exceptional tool.

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