Glaucoma Diagnosis & Expert Clinical Management

Understanding Glaucoma: The "Silent Thief of Sight"

Glaucoma is a group of progressive eye disorders characterized by damage to the optic nerve — the vital biological cable that transmits visual impulses from the retina to the brain. In most cases, this damage is closely linked to elevated pressure inside the eye (intraocular pressure, or IOP).

Because glaucoma typically causes no pain and begins by eroding peripheral (side) vision first, up to 90% of individuals in India are unaware they have the condition until significant, irreversible vision loss has already occurred.

Types of Glaucoma

• Primary Open-Angle Glaucoma (POAG): The most common form, where the eye’s drainage canals (trabecular meshwork) become gradually clogged over time, causing slow, painless pressure elevation.
• Angle-Closure Glaucoma (Closed-Angle): The iris bunches up against the drainage angle, blocking fluid exit. Can occur chronically or as an acute medical emergency with intense eye pain, headaches, nausea, and coloured halos around lights.
• Normal-Tension Glaucoma (NTG): Optic nerve damage and visual field loss occur even though eye pressure remains within the statistically normal range (below 21 mmHg).
• Secondary Glaucoma: Induced by diabetes (neovascular glaucoma), trauma, eye inflammation (uveitis), or prolonged topical steroid eye drop use.

Specialized Glaucoma Diagnostics at Ulwe Eye Clinic

Having completed an intensive long-term clinical fellowship at the prestigious L.V. Prasad Eye Institute (LVPEI), Dr. Susanta Chatterjee utilizes a comprehensive diagnostic battery:

• Goldmann Applanation Tonometry: Accurate, calibrated measurement of intraocular pressure.
• Gonioscopy: Direct visualization of the anterior chamber drainage angle to distinguish between open-angle and narrow-angle glaucoma.
• OCT Retinal Nerve Fiber Layer (RNFL) Profiling: Our in-house OCT scans measure microscopic nerve thinning, catching glaucoma years before visual field tests detect defects.
• Pachymetry (Corneal Thickness): Corrects IOP readings according to central corneal thickness.
• Automated Perimetry (Visual Field Analysis): Maps peripheral visual sensitivity to track stability over time.

Treatment & Management Approaches

While optic nerve damage cannot be reversed, timely treatment preserves your remaining vision for life:

• Targeted Medical Therapy: Advanced prescription eye drops (prostaglandin analogues, beta-blockers, alpha-agonists, carbonic anhydrase inhibitors) to reduce aqueous fluid production or enhance drainage.
• Laser Therapy: Nd:YAG Laser Peripheral Iridotomy (PI) for narrow-angle glaucoma to create a microscopic bypass channel and prevent acute angle closure attacks.
• Surgical Management (Trabeculectomy): Creating a new microscopic drainage flap (filtering bleb) for eyes that do not achieve target IOP through medication alone.