Treatments for glaucoma

There are different ways to operate on glaucoma, which are briefly described below:

Laser treatment

Laser rays are used in a variety of ways to treat cataracts.

Argon laser

This type of laser is used to open holes in the trabecular mesentery. This operation is called ALT and SLT operation. This method is useful for the treatment of open angle glaucoma.

Yag Laser

This type of laser is used to treat narrow angle glaucoma. It drills holes in the iris that act as an alternative drainage route.

Diode laser

This type of laser has been used to treat neovascular glaucoma. Modern research is now recommending that this laser can be used to treat open angle glaucoma.

Different surgical operation to create an an artificial route for drainage

There are different methods for creating artificial routes for drainage. These are used in different types of glaucoma. The following are the most commonly used:

• Trabeculectomy
• Trabeculotomy

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.

The signs which are searched by doctor

When the disease is just beginning, it is very difficult to diagnose. In practice, careful listening to the patient’s grief story is the most important thing that can lead to a diagnosis. At this stage, special to the patient’s history is the basis of the diagnosis. If the patient’s symptoms are not listened to carefully or their details are not known carefully, it becomes impossible to diagnose, because at this stage no reliable test for diagnosis has yet been discovered.

The eye is examined with a slit-lamp biomicroscope. This is the machine that won Nobel Prize when it was first introduced. In addition to general inspections, the following examinations are performed:

1. Anterior chamber depth (AC Depth):
   1. In many people the anterior chamber is shallow sice birth. This is the distance between the cornea and the iris. It is measured with the help of a slit lamp.
   2. when iris and cornea come very close to each other, it results into blockage in the draianage of the aqueous humour leading to rise in intraocular pressure.
2. Eye pressure.
   1. Measuring of eye pressure is very important in diagnosing this disease.
   2. There is a special problem that at the early stages of the intraocular pressure usually remains norma, sol whenever checked. there are very brief episodes of rise which are missed during diagnosis or It rises only during the episode.
   3. Therefore, the best way is to check the pressure when the patient feels the condition of attack. When the disease is severe enough, then this increase in pressure becomes a reliable feature.
3. Gonioscopy
   1. this is performed with the help of a special lens called gonioscope.
   2. This test directly evaluates the drainage site (the trabecular meshwork).

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۔