How narrow angle glaucoma is treated?

When acute congested glaucoma has been developed, thetreatment becomes almost impossible to treat. There are very few lucky ones whose eyes can be saved at this stage. If proper treatment is not given at this stage, then the eye becomes permanently blind. This attack should be treated urgently. Even one minute is precious at this stage. Many people who are blind due to glaucoma, they actually developed this stage. Best treatment is to prevent development of this critical stage! prophylactic measures are the actual treament!

If both the doctor and the patient behave as responsible persons and deal with the symptoms and signs carefully at the early stage of the disease, the narrow angle glaucoma can easily be diagnosed and the patient can be prevented from the accident of becoming blind. But unfortunately the eyes of many people in our country get lost idue to missing of diagnosis at early stage! One narrow angle glaucoma has been diagnosed or has been suspected, the patients should not waste time. Doctors should listen carefully to symptoms of the patients and should not neglect to check the intraocular pressure.

Treatment methods

• The treatment of this disease depends on the stage at which the patient comes to the doctor.
• At the early stages of the disease, first priority treatment is laser treatment. Most patients can be treated with a laser. With the help of a laser machine, a thin hole is made inside the iris. This acts as alternative route of drainage in case of pupil blockage and prevents the development of the acute congestive stage. In other words, with this treatment at an early stage glaucoma can disappear almost permanently.
• But if the severity of the disease has increased, the chances of benefiting from the laser are less. In this case, surgery is necessary. The vision may not be recovered completely with surgery, but timely surgery can prevent blindness.
• If there are some operative risks or if it is necessary to postpone the operation due to some other illness, then the treatment with medicines can also be considered.

Why does this disease occur? What is wrong with the eye?

There is a filter at the junction of the cornea and the iris. It is forms a sieve which is called the trabecular meshwork. There is a system at this place that drains the material from the eye to the blood vessels. For various reasons, the cornea and the iris become so close to each other that the material does not reach the trabecular meshwork, so the drainage is blocked. The fluid accumulates inside the eye. This leads to rise in the pressure within the eye.

• The structure of the anterior chamber is abnormal in some patients, especially in younger patients. As a result of which the aqueous drainage system does not work properly, as a result the pressure in the eye rises. This raised intraocular pressure causes damage to the optic nerve.
• In many patients, the iris and the cornea come so close to each other that the aqueous cannot reach the sieve and accumulates within the eye. As a result, the pressure in the eye increases, which damages the optic nerve.
• In many patients, persistent inflammation develops membranes which covers the holes in the sieve, and thus closes the holes. As a result, the pressure in the eye increases, which damages the optic nerve.
• In many patients the cornea and iris become attached to each other and adhesions develop leading to permanent closure of the angle and hence permanent blockage of whole or some parts of the angle. As a result, the pressure in the eye increases, which damages the optic nerve.

Symtoms of this type of glaucoma

The symptoms of this type of glaucoma vary from patient to patient. Because the symptoms depend on the patient’s stage of the disease. In addition, some of the symptoms are those that can be seen only with the use of various instruments and there are many of the symptoms that are felt only by the patient; can not be measured by any instrument.

The symptoms perceived by patients

Thepatients with this type of glaucoma suffer from so severe discomfort that they are forced to see a doctor. Severe  eye pain, headache, vision loss, blurring, etc. are some of the symptoms that make it difficult for anyone to stay home. Consider it in detailed manner:

1. A patient who is still in the early stages of the disease may occasionally feel as if the head has become heavy for a short period of time. Sometimes there are mild episodes of headache, but after a while these symptoms go away automatically, or they can be cured by using a variety of magic tricks, some are relieved by a doctor’s pill or injection. Someone says I use some homeopathic or herbal medicine and I get better. Many associate this reief with some religious act. We can call this period of distress an attack. This stage is called prodromal stage. Apparently the attack relievs and the credits goes to various drugs and religious healers etc. but in fact it lays some permanent damage to the eyes, and the damage accummulates with each attack! The disease progresses gradually, just as termites grow inside the wood. Many patients are not diagnosed as glaucoma at this stage, although this is the stage in which glaucoma are 100% curable. The main reason for not being diagnosed is that patients do not go to an eye specialist. Or if goes to doctor, they miss to measure the IOP.
2. When the disease progresses, some blurring is also felt in front of the eyes during the attack, and colored circles also appear when looking at the bulb. This is actually pointing out that the obstruction in the aquous drainage has been increased considerably and the eye pressure has now begun to increase considerably leading to cprneal edema. The loss caused by each stroke increases the oveall damage.
3. At the next stage of glaucoma, the patient develops redness in addition to pain in the eyes during the attack. And in addition to some of the heaviness and redness of the eyes, there is a gradual decrease in vision; at this stage also many times eye specialists also make mistakes due to hurry and do not check eye pressure. They treat the patient as a patient of allergic or other conjunctivitis. This stage is called chronic congestive glaucoma.
4. If the treatment opportunity is wasted at this stage, then the notorious attack of glaucoma develops. This stage is called acute congestive glaucoma. It is the notorious form of the disease which is commonly called glaucoma in the popular sense. Following symptoms may occur during this visit:
   1. The patient has a severe headache.
   2. There is severe pain inside the eye.
   3. Many patients come and say that they have not been able to sleep for two or three days due to the severity of the pain.
   4. Severe vomiting occurs and cholera is being treated.
   5. There may be a state of intoxication.
   6. There is a sudden decrease in vision.

In such condition, the patient often has to be hospitalized.

This laser machine is used to treat

• Narrow angle glaucoma.
• After-cataract which develops in eyes which have been operated for cataract..

In the following picture glaucoma is being treated.

یہ لیزر مشین جسے Yag laser کہتے ہیں درج ذیل مقاصد کیلئے استعمال کی جاتی ہےَ:

• نیرواینگل گلوکوما  کے علاج کیلئے۔ اس کے ذریعے آئرس میں سوراخ کئے جاتے ہیں جو نکاسی کے لئے متبادل راستے کا کام کرتے ہیں۔
• سفید موتیا کے اپریشن کے بن جانے والی جھلی کو ختم کرنے کیلئے۔