Glaucoma is a disease of the optic nerve. The optic nerve carries electrical signals from the eye to the brain and damage to it causes blind spots or non seeing areas to develop. Glaucoma is usually a silent disease and also dangerous as the damage to the nerve is irreversible. By the time a person realises the symptoms, the disease is usually advanced, thus making early detection & treatment very important especially for older people.

Eye is like a ball where a clear liquid called as aqueous humor is constantly produced in small quantity while an equal amount flows out through microscopic drainage system. When this drainage angle is blocked, excess fluid is retained, raising the pressure within the eyeball. This raised pressure pushes against the optic nerve and damages it. Sometimes there may be an acute attack due to sudden blockage causing a steep rise in the pressure with acute symptoms. This is an emergency.

	Open Angle Glaucoma: Blockage of the trabecular meshwork slows drainage of the aqueous humor, which increases intraocular pressure.
	Angle Closure Glaucoma: The angle formed by the cornea and the iris narrows, preventing the aqueous humor from draining out of the eye. This can lead to a rapid increase in intraocular pressure.

Open Angle Glaucoma	Angle Closure Glaucoma

	Blurred Vision
	Severe Eye Pain
	Headache
	Nausea/ Vomitting
	Rainbow Haloes Around Lights

Risk Factors :

	Age
	Elevated Eye Pressure
	Family History of Glaucoma
	High Refractive Errors
	Past Eye Injuries
	Thinner Central Corneas
	Diabetes and Migraine Headache

	Regular eye examinations with routine measurement of intra ocular pressure.
	Ophthalmoscopy to check the optic nerve.
	Gonioscopy and Ultrasound Bio Microscopy (UBM) to check the drainage angles.
	Visual field analysis to check the function of the optic nerve.
	Pachymetry for central corneal thickness.
	Newer imaging modalities like OCT, HRT & GDX may be required to document the anatomical damage to the optic nerve.

Treatment:
The treatment is aimed at arresting the progress of the disease. It is in the form of eye drops, laser and surgery. There are a variety of anti glaucoma medications available which has reduced the need for surgery. Some eye drops work to reduce the production of Aqueous humor, whereas some work to open the drainage channels. Also a combination of eye drops is available for enhanced effect.

Laser iridectomy or trabeculoplasty is helpful in certain cases to increase the drainage of fluid from the eye. The surgical techniques of trabeculectomy or modified trabeculectomy, with mitomycin C are to be undertaken if medication is not able to arrest the progression of the disease.

The treatment is tailor made for each patient and will require frequent check ups.