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Glaucoma is a condition in which abnormally high pressure created by an accumulation of fluid in one or both eyes damages nerve fibres.  Unless detected early and controlled through medications or surgery, glaucoma causes irreversible loss of vision.
 
Our Glaucoma Department - offers early diagnosis and treatment modalities for Glaucoma, a silent thief of sight and Vision threatening disease. A silent killer, Glaucoma is one of the very common eye problems in India Specialized in Glaucoma, Dr.Nirmal Fredrick, has set a complete Glaucoma care unit at by introducing latest diagnostic equipments, Laser units, protocol based medical care and the advanced surgical modalities to detect, treat and control this sight threatening disease. Our departmentis one of the few centres specializing in Glacuoma drainage devices, non penetrating filtering procedures and trabeculotomes for congenital glaucoma.
 
Screening of High Risk patients for Glaucoma, Advanced visual field analyser, Gonioscopy, Slit imaging, Pachymetry, Non Contact and Contact tonometer to Eye pressure and Nidek OCT scan to study the Optic Nerve head, make this unit an important part of our comprehensive eye care facility.
 
Diagnostic Equipments :
 
The following series of tests can be done to detect or diagnose glaucoma.
 
Tonometry : Tonometry is a simple, painless procedure that measures your intraocular pressure. It is usually the initial screening test for glaucoma. We have two types of Tonometry equipments. The Non contact or airpuff tonometer is used for screening and followup of intraocular pressure.  Apart from the standard goldmanapplanation tonometer, we also have the latest I care Tonometer, which gives accurate digital reading in few seconds.
     
Visual Field Ttest : A’ Visual Field Test’ helps to detect how much your visual field has been affected by glaucoma. At our centre we have the ‘state of the art’ ‘Humphrey Field Analyser. It is a highly advanced and accurate machine with excellent reproducibility. The tests are simple and easy for all type of patients. It is used to screen patients for early visual field defects, follow up of glaucoma and retinal patients and also useful in detection neurological defects.
 
     
Pachymetry : It is a medical device used to measure the thickness of the cornea. It is used prior to Lasik surgery and is useful in screening for patients suspected of developing glaucoma. We have the conventional pachymetry machine and the most advanced Anterior segment OCT for measuring the corneal thickness.
 
     
Gonioscopy : This test helps us to determine whether the patient has ‘Open angle’, ‘Closed angle’ or ‘Narrow angle’ Glaucoma. Our center is equipped with all diagnostic lenses – single, three and four mirror zeiss to assess the angle. Our Anterior segment OCT gives a more accurate picture in Angle closure glaucoma patients.
 
     
Ophthalmoscope / Funduscope : An instrument called Ophthalmoscope or slit Biomicroscope enables to visualize the fundus (mainly optic nerve and the surrounding retina) of the eye. The Optic nerve can also be assessed with our TOPCON Fundus camera  andstereophotography.
   
     
OCT: Optical Coherence Tomography (OCT) means imaging of cross sectional layers of the optic nerve and surrounding retina obtained by anlysing optical coherence patterns of light reflected from retina. It is popularly known as ophthalmic CT scan.

In Glaucoma, OCT helps to detect and measure :

Morphological changes
Thickness of retina & retinal nerve fibre layer.
Retinal Volume
The various parameters of the optic disc.
The analysis of retinal fiber layer and optic nerve head aids in identification of early glaucomatous loss.
 
     
Treatment Options : Medical management is aimed at reducing intra ocular pressure by improving aqueous outflow and reducing the production of aqueous with the help of good efficiency eye drops and systemic medication if required. Reducing the pressure in the eye reduces the progression of visual field loss. Standard practice has been to move on to surgery, if medications are ineffective or if the glaucoma patient has difficulty in adhering to the medical therapy recommendations.
 
     

Surgery :

At our centre, we have several types of surgeries to treat glaucoma, in case if the medication is ineffective or so. The surgery options available with us to treat Glaucoma are as follows.

SLT (Selective Laser Trabeculoplasty) : At our centre SLT(Selective Laser Trabeculoplasty) is done which uses a high-energy laser beam to shrink part of the trabecular meshwork, which causes other parts of the meshwork to stretch and open up. This helps aqueous humor drain more easily from the eye. This type of laser surgery is an out patient procedure that takes 10 to 20 minutes.

Usually, the patient immediately resumes normal activities without discomfort. Your eye pressure is checked one to two hours after the procedure and several times in the following weeks. It may take a few weeks for the full effect of the procedure to get established.

ND YAG Laser Peripheral Iridotomy :

Trabeculectomy : It is most frequently performed glaucoma surgery in the world today wherein an additional drainage system is created in the eye by removing small part of trabecular meshwork and iris. In high-risk cases it is combined with medicines like mitomycin C, implants or an additional surgical procedure.

 
                 
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