According to WHO, glaucoma is the prime cause for irreversible blindness in India. Glaucoma Diagnosis Gap in India highlights, about 1.2 million have been rendered blind and at least 12 million are affected. Glaucoma is a condition where an accumulation of fluid in the eye increases the intraocular pressure resulting in optic nerve damage. The prevalence of glaucoma increases with age. In India, there is a gap in glaucoma diagnosis that needs to be bridged by increasing awareness about the disease.
There are two types of glaucoma, primary open angle glaucoma, and angle-closure glaucoma. Primary open angle glaucoma is the more common of the two. The latter could entail an acute angle closure attack and the patient may need immediate help from an ophthalmologist for appropriate treatment including laser iridotomy. Primary open angle glaucoma is painless and develops gradually (is asymptomatic), hence the person does not perceive any changes in the vision in the early stage. The affected person realizes the change in vision only after glaucoma has brought about significant damage to the optic nerve.
Importance of Glaucoma Diagnosis
In India, almost 90 percent of those affected by the disease go undiagnosed. This gap in glaucoma diagnosis is alarming and early detection is crucial to prevent permanent blindness in patients. To detect any early signs of optic nerve damage due to open-angle glaucoma, ophthalmologists recommend regular eye exams to their patients. To be treated successfully, timely detection of the disease is critical.
In both, urban and rural India, awareness initiatives regarding risk factors and the importance of regular eye check-ups are the need of the hour. In rural regions, there is a scarcity of both awareness and qualified ophthalmologists who can detect and treat the condition. In the preferred practice patterns of the American Academy of Ophthalmology, comprehensive eye examinations are recommended for regular patients to rule out glaucoma after the age of 40 years. However, this does not happen as a routine in India. Hence awareness about glaucoma and the need for comprehensive checkup needs to be emphasized.
Diagnosis and Treatment Techniques
General ophthalmologists or sub-specialists carry out diagnoses for glaucoma in India. Treatment is customized and may vary based on the type of glaucoma.
To detect glaucoma, eye-specialists carry out a series of tests to check the extent of the damage. The three screening tests comprise of the intraocular pressure, gonioscopy (a test to check the fluid drainage channels in the eye), examination of the optic nerve (nerve that connects the eye to the brain), and a test to check for non-seeing areas (scotomas) in the patient’s field of vision. Once diagnosed, open-angle glaucoma is treated with eye drops to alleviate the pressure in the eye. The patient must diligently take the eye drops life long as prescribed by the treating doctor. If the eye drops do not help to control glaucoma, the specialist may suggest alternatives like laser or surgery.
Individuals interested in understanding the diagnosis, treatment, and management of glaucoma can sign up for our ICO certified course. It covers topics including pathophysiology of glaucoma, Intraocular pressure, gonioscopy, disc evaluation, visual field testing, role of imaging, medical management and surgical options and management.
Check out course – Comprehensive Course on Open Angle Glaucoma
Dr. Sirisha Senthil, MS, FRCS
Consultant, VST Centre for Glaucoma
L V Prasad Eye Institute, Kallam Anji Reddy Campus.