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Diagnostic Facility
Regular glaucoma check-up in Sudharshana Nethralaya includes a detailed history and ocular examination.
The technique of measurement of pressure within the eye (Intra ocular pressure – IOP/IOT) is called tonometry. This is very important since IOP is one of the indicators of Glaucoma. Tonometry is recommended in everyone over the age of 40, family history of glaucoma, Myopia, Diabetes and any history of previous ocular injuries. This technique can be performed with either applanation or non-contact tonometer.
Ophthalmoscopy is used to examine the inside of the eye, especially the optic nerve. In a darkened room, the doctor will examine your eye by using an ophthalmoscope (an instrument with a small light on the end). This helps the doctor to look at the shape and colour of the optic nerve.
If the pressure in the eye is not in the normal range, or if the optic nerve looks unusual, then one or two special glaucoma tests will be done.
The perimetry test is also called a visual field test. During this test, you will be asked to look straight ahead and then indicate when a stationary light appears in the field of vision. This helps draw a "map" of your field of vision. This is a non-invasive computerised test which takes about 10-20 minutes to perform and gives information regarding optic nerve damage due to glaucoma. In Sudharshana Nethralaya, we have Humphrey Zeiss Visual Field Analyser which is used for both diagnosis and follow up of Glaucoma.
  Glaucoma and Optic Nerve Head Digital Photography
    The photographs below demonstrate various degrees of optic nerve head cupping caused by increased intraocular pressure.
Normal disk photo   Early stage glaucoma   Moderate stage glaucoma  
Advanced stage glaucoma
  Treatment Modalities
Glaucoma is usually controlled with eye drops instilled daily which prevent damage to the optic nerve by lowering eye pressure, either by slowing the production of aqueous fluid within the eye or by improving the out flow of the eye.  Recently there have been a few new medications which show great promise for more effectively controlling eye pressure. In order for these medications to work, you must take them regularly and continuously as they are prescribed. Quite simply, the key to the success of medication therapy is patient compliance.
  Yag Laser Iridotomy
Yag laser iridotomy is performed almost exclusively for patients with narrow angle glaucoma, or acute angle closure glaucoma. Yag laser iridotomy involves making a tiny opening in the iris with a laser, which allows fluid to drain freely. The laser peripheral iridotomy procedure is usually completed as a brief outpatient procedure. Prior to the procedure, the pupil is often constricted with an eye drop medication known as pilocarpine. The procedure itself is completed with the patient seated at the laser, and requires no sedation. The entire procedure only takes a few minutes. Vision will quickly return to normal. After the procedure, your eye specialist may recommend anti-inflammatory eye drop medications for the next few days. A post-op visit will be scheduled.
Yag Laser Iridotomy in Progress   Iridotomy
When glaucoma continues to progress despite the use of medication regimens and possibly laser treatments, a glaucoma filtration procedure (trabeculectomy) may be recommended. The goal of the glaucoma filtration procedure is to create a new passageway by which aqueous fluid from inside the eye can escape, thereby lowering the pressure.
In cyclocryotherapy, an extremely cold instrument (probe) is repeatedly applied to the sclera, the white part of the eye. The probe destroys the ciliary body, the part of the eye that produces fluid. Cyclocryotherapy may be used to treat severe glaucoma that has not improved after other types of treatment or surgery have been tried
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