Best Neuro Ophthalmologist in Mumbai

The most prevalent form of glaucoma is known as primary open-angle glaucoma. In this type, the drainage passage for the fluid within the eye remains open, allowing fluid outflow. However, there may be a flaw in the drainage pathway, resulting in increased resistance to fluid drainage, leading to heightened eye pressure. In a small percentage of cases, increased fluid production can also contribute to the elevated pressure. This type of glaucoma develops slowly and does not initially present any symptoms. It first affects the side vision, gradually progressing towards the center of vision. Due to this gradual progression, many individuals may remain unaware of their condition until they experience significant vision loss that affects their central vision.

Risk factors for primary open angle glaucoma are:

• Age more than 40 years
• Race – African Americans
• Family history of glaucoma
• Systemic diseases such as diabetes mellitus, hypertension, heart disease
• High myopia or those with a high minus power

Angle closure glaucoma, also known as closed angle glaucoma, is the second most common type of glaucoma and is characterized by narrow drainage channels in the eye. If the angle gradually closes over time, it is referred to as chronic angle closure, while a sudden closure of the angle leads to an acute angle closure attack. Acute angle closure glaucoma presents as a medical emergency. During an acute attack, the patient experiences symptoms such as eye pain, nausea, vomiting, redness, blurred vision, and colored halos due to a rapid increase in eye pressure. Immediate treatment by an eye specialist is essential in such cases.

Risk factors for angle closure glaucoma:

• Age more than 40 years
• Race – East Asians
• Family history of glaucoma
• Women
• High hypermetropia or those with a high plus power

Normal tension glaucoma, also referred to as low tension glaucoma, is a type of glaucoma where damage to the optic nerve can occur despite the eye pressure being within the normal range. The exact cause of this condition is not fully understood, but it is believed to stem from either an exceptionally delicate optic nerve that can be harmed even with normal eye pressure or reduced blood flow to the optic nerve. This type of glaucoma is often asymptomatic, and individuals typically do not experience any visual complaints until the disease reaches a very advanced stage.

Risk factors for normal tension glaucoma are:

• Family history of normal tension glaucoma
• Race – Japanese ancestry
• Thinner corneas
• Heart disease
• Migraine and peripheral vascular disease

Glaucoma during infancy and childhood is a relatively uncommon but serious set of diseases that can jeopardize vision. Infants and young children with glaucoma are usually brought for an eye examination because either their parents or pediatricians have observed some peculiarities in their eyes. These signs may include whitish discoloration and enlargement of the eyes, excessive tearing, a tendency to keep the eyes closed, and sensitivity to light. Glaucoma in children may arise if there’s a family history of glaucoma, if the parents have had a consanguineous (close blood relation) marriage, or due to abnormal development during pregnancy.

This type of glaucoma occurs due to an irregular flow of intraocular fluid within the eye caused by a blockage or dysfunction of the trabecular meshwork, which are the drainage canals in the eye with a mesh-like structure. Alternatively, in certain instances, the abnormal drainage system can be a consequence of another eye or body condition, leading to what is known as secondary glaucoma.

Congenital glaucoma is identified through a comprehensive eye examination, typically conducted under sedation in the operating theater for infants and children below the age of 3. Early detection and treatment of congenital glaucoma can help slow down the progression of the condition. Microsurgery is often used to address structural defects in straightforward cases of congenital glaucoma. For more complex cases, a combination of medication and surgery is employed for treatment.

Secondary glaucoma refers to specific types of glaucoma in which the underlying reason for increased eye pressure leading to optic nerve damage and vision loss can be identified. Various factors contribute to secondary glaucoma, such as the prolonged and unregulated use of steroids, severe diabetic retinopathy, eye injuries, inflammation of the eye (uveitis), or advanced stages of cataract.

If you suspect having any of these risk factors, it is important to undergo an eye examination. Remember to inform your eye doctor about your specific risk factors, which will assist them in determining the frequency of your eye check-ups. The type of treatment prescribed will be based on whether you have open-angle or angle-closure glaucoma.

Pigmentary Glaucoma is classified as a type of secondary open-angle glaucoma. It occurs when pigment granules from the back of the iris, the colored part of the eye, enter the clear fluid produced inside the eye. Over time, these tiny pigment granules flow towards the drainage canals of the eye, gradually obstructing them and leading to increased eye pressure. As more pigments are released, patients may experience blurred vision during physical exertion or exercise. This type of glaucoma is frequently observed in young males who have high nearsightedness and wear strong minus power lenses.

Secondary open-angle glaucoma can be a result of eye injury. Traumatic glaucoma can manifest immediately after the injury or emerge years later. It can be triggered by blunt trauma, which bruises the eye, or by penetrating injuries. In most cases of blunt trauma, the elevated eye pressure is temporary. However, there are instances where the drainage canals in the eye sustain damage and permanent scarring occurs. This scarring obstructs fluid flow and may lead to glaucoma even years after the initial injury.

Furthermore, conditions like myopia (nearsightedness), previous eye injury, infections, or past surgeries can increase the susceptibility of the eye to severe injuries.

Pseudoexfoliative Glaucoma, a type of secondary open-angle glaucoma, occurs when a flaky material similar to dandruff peels off from the outer layer of the eye’s lens. This material accumulates in the angle between the cornea and iris, potentially blocking the eye’s drainage system and leading to increased eye pressure. Pseudoexfoliative Glaucoma is frequently observed in individuals of Scandinavian descent.

Individuals diagnosed with exfoliative glaucoma commonly experience more instances of elevated eye pressure, greater fluctuations in pressure, and higher peak pressures compared to patients with other forms of glaucoma. Managing this type of glaucoma with medical treatment alone is typically more challenging. Patients with exfoliative glaucoma necessitate aggressive medical therapy and are more likely to require laser or surgical interventions. Regular and frequent visits to their eye doctor are often essential to closely monitor the progression of the disease.

A type of secondary open-angle glaucoma can be triggered by the atypical growth of new blood vessels on the iris and across the eye’s drainage channels.

Neovascular glaucoma is invariably linked to other conditions, most commonly diabetes and hypertension. It never develops in isolation. The emergence of new blood vessels obstructs the normal drainage of eye fluid through the trabecular meshwork, resulting in elevated eye pressure. This type of glaucoma advances swiftly and poses significant challenges in terms of treatment.