Glaucoma Surgery Cost in India

Glaucoma is a group of related conditions in which there is gradual loss of vision due to damage to the optic nerve which is caused by high intraocular pressure. It is one of the important causes of blindness after 60 years of age.

TYPES OF GLAUCOMA –

1. OPEN ANGLE GLAUCOMA – in this type , there is impaired drainage of the aqueous humor by the trabecular meshwork. Aqueous humor is the fluid which is found in front of the lens of the eye and its insufficient drainage causes rise in the pressure of the eye ( Intraocular pressure, IOP) which gradually leads to optic nerve damage and loss of vision.

The loss of vision in this type is gradual and painless and by the time, the patient may present it may be already too late. Usually affects middle aged individuals however can be seen earlier too.

2. ANGLE CLOSURE GLAUCOMA – in this type, due to some anatomical predispositions, some individuals have a narrow angle of the eye, which is formed by Iris and cornea. In certain situations, the iris bulges and blocks this angle and leads to a spike in the IOP which causes severe eye pain and marked decrease of vision. It may occur all of a sudden ( acute angle closure) or gradually ( chronic angle closure). Acute angle closure is an ophthalmological emergency.

Other subtypes of glaucoma are-

3. Normal tension glaucoma – in this even though the IOP remains normal, there is continued damage to the optic nerve. This is because there is diminished blood supply to the optic nerve. An important cause is atherosclerosis.

4. Congenital/ developmental glaucoma – this is most commonly seen in infant and kids. It may either be from birth or may present after a few years of birth.

5. Pigmentary glaucoma – in this pigment granules released from the iris, block the trabecular meshwork which is the drainage system of the eye. This leads to build up of pressure inside the eye and presents like an episode of angle closure glaucoma with marked eye pain and headache, diminished vision, nausea and vomiting, marked sensitivity to light and inability to open the eyes. this is exacerbated by physical activities like exercises, running and jogging

6.There can be other types of glaucoma like after eye surgeries like cataract , vitrectomy, after injury to the eyes and after other diseases of the eyes.

SYMPTOMS – symptoms of glaucoma mainly include –

initially there may be loss of peripheral vision followed by painless, gradual loss of vision ( open angle glaucoma)
headache, eye pain, marked diminution of vision, nausea and vomiting ( angle closure glaucoma)

FREE CONSULTATION

Name

EMAIL ADDRESS

PHONE NUMBER

Country

Specify your Problem

Treatment of glaucoma

It is mandatory to treat glaucoma because prolonged increase in intraocular pressure can lead to continued optic nerve damage and permanent blindness. Patients may also have a painful blind eye especially in Chronic angle closure glaucoma.

A patient who is a glaucoma suspect or known case of glaucoma needs to undergo meticulous examination and various test like field testing, optic nerve head imaging , optical coherence tomography to assess the retinal nerve fibre layer around the disc, which is especially sensitive for early cases.

The various modalities of treatments are

ANTI GLAUCOMA MEDICATIONS – in many types of glaucoma, anti glaucoma drugs are the first line of treatment and can control the pressure effectively especially if the patient has a very good compliance.

However, there are multiple limitations

Side effects of the drugs itself
Need of multiple medications
Poor compliance of the patient
Ineffective IOP control

2.SURGERIES FOR GLAUCOMA –

LASER TRABECULOPLASTY – prior to incisional surgery, many surgeons advocate laser treatment of the trabecular meshwork which improves drainage and lowers the intraocular pressure.

In cases of Angle closure Glaucoma, Laser peripheral iridotomy is done in which a hole is made in the peripheral iris which improves drainage in the shallow anterior chamber and also prevents further attacks of angle closure.

TRABECULECTOMY – in this a new drainage hole is created by the instruments. The intraocular fluid now bypasses the blocked trabecular meshwork and flows through the new drainage pathway. The small opening created is covered by thin scleral flap and the fluid drains out forming a thin bleb which is covered by the upper lid.

This surgery achieves a good lowering of intraocular pressure. How ever, there are few limitations of this surgery.

This surgery doesn’t work well in certain types of glaucomas
It can cause sudden marked lowering of IOP which may require further intervention.
There is always a risk of SNUFF OUT phenomena in advanced glaucomas. In this the remaining vision may also get compromised due to surgery.
There is always a risk of infection in the bleb
There may be sudden rise of IOP after surgery due to certain causes (Supra choroidal hemorrhage)
There is a risk of cataract formation

3. GLAUCOMA DRAINAGE DEVICES –

in this type of surgery, alternate way of aqueous outflow is achieved through special devices known as drainage devices. These are special kind of tubular devices with valve at one end to regulate the amount of fluid flow. However, they may now come in varied shapes. These are implanted in the anterior chamber of the eye and the fluid flows through this outside to an external reservoir. A fibrous capsule gradually forms around this reservoir few weeks after the surgery and then regulates the flow of the fluid.

Patient needs a meticulous follow up after surgery because the capsule forms around the device in 4 to 6 weeks and the patient has to be closely monitored so as to detect the complication at its earliest.

The complications commonly encountered are –

Hypotony – its due to sudden lowering of IOP, wherein the eye of the patient becomes very soft.
Sometimes there may be blood in the anterior chamber especially if it is a case of neo vascular glaucoma.
Valve related complications
Tube related complications – the tube may migrate anteriorly towards the cornea or posteriorly towards the iris and lens. Anterior migration may irritate the cornea and posterior migration may cause cataract formation.

FAQs

What is the first sign of Glaucoma?

Loss of peripheral or side vision There may be gradual loss of vision in some cases Severe eye pain, headache, with nausea and vomiting, red eyes and hazy cornea with marked loss or vision may be seen in acute attack of angle closure Glaucoma.

What happens if you have Glaucoma?

Glaucoma occurs due to increase in the pressure of the eye which leads to optic nerve damage. if this is not treated timely then it can lead to permanent blindness.

Can Glaucoma be stopped?

Glaucoma if detected early can be slowed by taking anti glaucoma medications. Surgery may be needed if anti glaucoma medications fail to control the IOP and optic nerve damage.

However, if detected in late stages then it may be difficult to preserve the vision.

How quickly does glaucoma progress?

Untreated acute glaucoma can cause irreversible loss of vision. Chronic glaucoma if left untreated results in gradual loss of vision. However, timely detection and prompt treatment gives very good results and is vision saving.

What is the root cause of glaucoma ?

The root cause of glaucoma is elevated intraocular pressure which causes permanent optic nerve damage.

Can glaucoma be caused by stress?

There appears no direct relation between stress and Glaucoma.

What age do you get glaucoma?

It usually occurs above the age of 40. However, it may also occur in young adults, infants and kids. It occurs in African Americans at a younger age and causes more vision loss.

How can I lower me eye pressure naturally?

Eating a healthy diet, exercises, limiting caffeine intake and taking prescribed medications.

Can you live a normal life with Glaucoma?

Yes, if detected on time, the quality of life remains good on antiglaucoma treatment. Even in advanced cases, visual rehabilitation can be achieved by low vision aids.