Glaucoma refers to certain eye disturbances that affects the optic nerve and causes deterioration of vision and sometimes even vision loss.
It is characterized by progressive field loss due to nerve damage from elevated intra ocular pressure.
It is an important cause of blindness world wide and in the United States occurs in 1 to 2 percent of patients.
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The above pack is for 30 days. Following is the dosage details:
Punarnava Mandoor : 2 tablets thrice daily before meals.
Amalaki Rasayan: 2 capsules twice daily after meals.
Arogyavardhni Vati: 2 tablets twice daily before meals.
The disease may be asymptomatic with painless slow loss of peripheral and paracentral visual fields.
Early detection depends on a routine eye examination with intra ocular pressure measurement (tonometry) funduscopy with attention to optic disc appearance and visual field testing. But is not necessary that all of these diseases have an elevated eye pressure, the IOP. Normal measurement of IOP is 10-21 mm of Hg. An increased IOP is the most important factor for the development of glaucoma.
The elevated ocular pressure can also be termed as ocular hypertension. If one is diagnosed with ocular hypertension, it does not necessarily mean he is suffering from the disease, but he is at a higher risk susceptible to the disease.
Also many of them are unaware of the disease. So, it is always advisable to undergo certain eye tests and examinations voluntarily by consulting an ophthalmologist.
In the normal eye, the optic cups are symmetric and the neural rim is pink. In glaucoma, either localized notching or generalized enlargement of the optic cup can be seen. The rim, although thinned remains pink until late.
The normal cup-disc ratio is less than 0.2 to 0.3. Vertical disparity in one or both eyes is an early sign of glaucoma.
Glaucoma is often asymmetric and the finding of asymmetry of the cup-disc ratio implies glaucoma.
Early visual field loss includes non specific constriction and small paracentral scotomas.
Glaucoma is an appellation for many disease states. It results from decreased outflow of aqueous humor through the pupil, trabecular meshwork and Schlemm's canal leading to elevated intra ocular pressure.
Chronic or primary open - angle glaucoma, the most common of adult glaucoma's, is asymptomatic and only detected by routine eye examination. It is associated with relative obstruction to aqueous outflow through the trabecular meshwork and is of unknown cause.
Secondary open angle glaucoma may develop in patients with ocular inflammatory or neoplastic disease, with mature cataracts or elevated episcleral venous pressure or during a course of long term glucocorticoids therapy, either topical or systemic.
Angle-closure glaucoma occurs when the iris block egress of aqueous humor through the trabecular meshwork. In the primary form, an anatomic abnormality of the eye leads to papillary block and obstruction of the trabecular meshwork. An acute rise in intra ocular pressure with dilatation of the pupil causes severe eye and face pain, nausea, vomiting, colored halos around lights and loss of visual acuity.
Conjunctival hyperemia, corneal edema and a fixed mid dilated pupil are common signs. Urgent reduction of the intraocular pressure is best accomplished by the use of hyperosmotic agents including oral glycerine and sorbitol or intravenous mannitol.
Laser or surgical iridotomy is curative in most cases.
Secondary angle-closure glaucoma occurs when the lens or ciliary body becomes swollen, pushing the iris against the trabecular meshwork or sealing the iris to the trabecular meshwork as a result of the formation of neovascular network. This process occurs in patients with Diabetic retinopathy, advanced ocular ischemic syndrome due to severe occlusive carotid disease or inflammatory adhesions.
The pressure inside the eyes is measured with the help of an instrument known as Tonometer.
Also another method of examining the eyes is dilatation of pupils. This test is done to ensure an adequate examination of the optic nerves. Here drops are placed in the eyes to widen or dilate the pupils. Then the eyes are viewed with the help of a magnifying glass by the Ophthalmologist to check for any signs of damage of the optic nerves or any other eye problems.
Treatment includes the use of topical agents including cholinergic (pilocarpine, carbachol, echothipate) or adrenergic agonists (epinephrine dipivefrin) or antagonists i.e. beta - adrenergic blockers (timolol, levobunalol, betaxolol).
If topical agents do not reduce the intra ocular pressure satisfactorily, systemic carbonic anhydrase inhibitors (acetazolomide or methazolamide) are added.
Laser trabeculoplasty or filtration surgery, to improve aqueous outflow is indicated when medical therapy fails.
Glaucoma can sometimes be treated by placing drops inside the eye that contain a drug that diffuses into the eyeball and reduces secretion or increases absorption of aqueous humor. When drug therapy fails, operative techniques to open the spaces of the trabeculae or to make channels directly between the fluid space of the eye ball and the sub conjunctival space outside the eyeball can often effectively reduce the pressure.