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Glaucoma check-up and treatment in Vasco, Goa

Glaucoma is a group of eye diseases that damage the optic nerve, the cable that carries signals from the eye to the brain. In Hindi it is often called kala motia and in Marathi kachbindu; it is different from cataract (motibindu, motiyabind). The most common type does not hurt or blur vision until a lot of side vision is lost, and that lost vision does not come back. Studies in India suggest that most people who have glaucoma do not know it. Found early and treated, glaucoma usually progresses slowly enough for people to keep useful sight for life.

What causes glaucoma?

The front of the eye is filled with a clear fluid that is made all the time and drains out through a fine mesh in the angle where the iris meets the cornea. If the fluid drains too slowly, the pressure inside the eye rises and presses on the optic nerve. Over months and years, nerve fibres are lost, first from the side vision. Raised eye pressure is the main risk factor, but glaucoma can also occur with pressure in the normal range, and some people with high pressure never develop it. Read what normal eye pressure means.

What are the types of glaucoma?

• Open-angle glaucoma. The most common type. The drainage angle is open, but the drainage works poorly. It develops slowly and silently.
• Angle-closure glaucoma. The drainage angle is narrow and can close. It is more common in people of Asian origin, including Indians, and in people who are long-sighted. It can come on slowly, or as a sudden attack, which is an emergency.
• Secondary glaucoma. Caused by something else: an old eye injury, inflammation inside the eye, advanced diabetic eye disease, or the long-term use of steroid medicines, including steroid eye drops.
• Childhood glaucoma. Rare. A baby with large or cloudy eyes, constant watering and discomfort in light needs an urgent eye check.

What are the symptoms of glaucoma?

In open-angle glaucoma, usually none until late, when side vision is lost and the world seems to narrow. In an angle-closure attack, the opposite: sudden severe eye pain, a red eye, blurred vision, coloured haloes around lights, headache, and nausea or vomiting. An attack needs treatment within hours; emergency eye care at ReNew Vision is available 24 hours, so come in at once, day or night, or see eye emergency. Read the full guide: what are the symptoms of glaucoma?

Who should be checked for glaucoma?

• everyone from about 40, as part of a complete eye check-up, and then as advised
• anyone with a parent, brother or sister with glaucoma; see is glaucoma hereditary?
• people with diabetes, high short sight or long sight
• people who have used steroid tablets, inhalers, creams or eye drops for a long time
• people with an old eye injury or past inflammation inside the eye

How is glaucoma checked at ReNew Vision?

1. Your history: family history, medicines (especially steroids), eye injuries, diabetes and blood pressure.
2. Vision and spectacle power.
3. Eye pressure test (tonometry). The test takes a few seconds.
4. The drainage angle. The eye doctor examines the angle under magnification, sometimes with a special lens placed gently on the numbed eye, to see whether it is open or narrow.
5. The optic nerve. The eye doctor examines the optic nerve at the back of the eye, often after dilating drops, looking for the typical changes of glaucoma.

Visual field test: this test, which maps your side vision, is not done at ReNew Vision. If you need one, the eye doctor will tell you and explain the next step, and you can bring the results to your follow-up here. Scans of the optic nerve (such as OCT) are not done here either; if you need one, the eye doctor will tell you and explain the next step.

How is glaucoma treated?

The aim of every glaucoma treatment is to lower the eye pressure enough to protect the optic nerve and keep the sight you have. Treatment cannot bring back vision that is already lost, so the earlier it starts, the more sight is kept.

Eye drops

Most people with open-angle glaucoma start with daily eye drops that lower the pressure. They work only while you use them, usually for life. Use them at the same times every day, keep your eyes closed for a minute after each drop, and do not stop when the bottle runs out or because your eyes feel fine. Bring your drops to every visit. If a drop makes your eyes red or uncomfortable, tell the eye doctor; there are other choices.

YAG laser iridotomy

For a narrow drainage angle, the YAG laser makes a tiny opening near the edge of the iris, so that fluid can reach the drainage angle by another route and the angle is less likely to close. It is done at ReNew Vision. Numbing drops are used and a lens is placed on the eye; most people feel brief, sharp clicks or a mild ache. Vision may be blurred for a short while, and the pressure is checked afterwards. Not every narrow angle needs laser: the eye doctor advises whether one eye, both eyes or neither should be treated, depending on how narrow the angles are and what else is found.

Trabeculectomy (glaucoma surgery)

When drops and laser are not enough, or are not suitable, the eye doctor may advise trabeculectomy, which is done at ReNew Vision. The surgeon makes a new drainage channel under a thin flap in the white of the eye. Fluid drains through it into a small blister (a bleb) that sits under the upper eyelid, where it cannot be seen. It is done under local anaesthesia. There are many follow-up visits in the first weeks, while the drainage is adjusted. Some people need fewer drops afterwards and some still need drops. Possible problems include pressure that is too low or too high, faster growth of a cataract, and infection, which can happen even years later. After a trabeculectomy, a red, sticky or painful eye needs to be seen the same day.

Other glaucoma lasers and drainage implants are not done at ReNew Vision. If your eye needs one, you are referred.

Glaucoma and cataract

Glaucoma and cataract often occur together in older eyes. In some eyes with narrow angles, cataract surgery also widens the drainage angle. If you have both, the eye doctor plans the order of treatment with you; see cataract surgery in Vasco.

What does glaucoma follow-up involve?

Glaucoma is a lifelong condition, like high blood pressure or diabetes. Follow-up visits, every few months at first, check your eye pressure and optic nerve, and how well the treatment is working. If you need visual field tests, the eye doctor tells you how often. Missing visits and drops is the main reason people lose sight from glaucoma. If getting here is the problem, we can collect you from your home and drop you back, at zero cost to the patient; ask when you call.

How do I book a glaucoma check-up?

• Where: ReNew Vision Eye Hospital, 2nd floor, Pai Hospital building, Vaddem Merces Road, Vaddem, Vasco da Gama, Goa 403802. See timings and directions.
• When: Eye OPD Monday to Saturday, 4 pm to 7 pm. Sunday OPD closed. Emergency eye care: 24 hours.
• Call or WhatsApp: 072489 88039.
• Bring: your spectacles, all your eye drops, earlier reports and visual field results, a list of your medicines, and someone to take you home if dilating drops are used.

Glaucoma guides

EMI facility is available for treatment and services above ₹30,000.

Questions patients ask

Can glaucoma be cured?

No, but it can usually be controlled. Lowering the eye pressure with drops, laser or surgery slows or stops further damage. Vision already lost cannot be restored, which is why early checks matter.

Is glaucoma surgery done at ReNew Vision?

Yes. Glaucoma care here includes screening and follow-up, YAG laser iridotomy for narrow drainage angles and trabeculectomy (glaucoma surgery) when the eye doctor advises it. Other glaucoma lasers and drainage implants are referred.

Do I need glaucoma eye drops for life?

Usually, yes. The drops lower the pressure only while you use them. Never stop them on your own. If they cause side effects, tell the eye doctor, because there are other drops, laser and surgery.

Is a visual field test done at ReNew Vision?

No. If you need a visual field test, the eye doctor will tell you and explain the next step, and you can bring the results to your glaucoma follow-up at ReNew Vision.

Can I have glaucoma with normal eye pressure?

Yes. Some people develop glaucoma damage with pressure in the normal range. That is why a glaucoma check looks at the optic nerve and the drainage angle as well as the pressure.

Is kala motia the same as glaucoma?

Yes. Kala motia (Hindi) and kachbindu (Marathi) are common names for glaucoma. Motibindu and motiyabind mean cataract, which is a different condition.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.