Glaucoma : A Review

Abstract

Glaucoma is one of the most common ophthalmic conditions encountered in primary and secondary care. The glaucoma is a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. It is usually associated with an increase in intraocular pressure (IOP) above the normal value—usually estimated at 21 mm Hg. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. Introduction Glaucoma is a leading cause of irreversible blindness throughout the world. In India glaucoma constitute 2% of total blindness (1). Moreover, the management of glaucoma has an enormous impact in our society in terms of patient’s morbidity, loss of productivity, number of ophthalmic consultations and health costs, as these patients may have to continue the therapy for the whole life. However, new glaucoma medications have increased efficacy, reduced dosing frequency and improved side effect profiles; but there is need for comparing the cost of new glaucoma medication with the traditional one (2). Glaucoma is an optic neuropathy in which the optic nerve is damaged with typical loss of nerve fibers and increasing cupping of the optic disc, leading to progressive, irreversible loss of vision. It is often, but not always, associated with increased pressure of the fluid in the eye. The nerve damage involves loss of retinal ganglion cells in a characteristic pattern. There are many different sub-types of glaucoma but they can all be considered a type of optic neuropathy. Raised intraocular pressure (IOP) is a significant risk factor for developing glaucoma (3). Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness. Glaucoma has been nicknamed the “sneak robber of sight” because the loss of vision normally occurs gradually over a long period of time and is often only recognized when the disease is quite advanced. Once lost, this damaged visual field cannot be recovered. Worldwide, glaucoma is the second leading cause of blindness and affects approx 66 million people in the world. In some countries, e.g. United States of America were approximately 100000 people are totally blind and approx 300000 are blind in one eye from glaucoma, it is the leading cause of blindness. Glaucoma affects 1 in 200 people aged fifty and younger, and 1 in 10 over the age of eighty (4, 5 & 6). Glaucoma is one of the most common ophthalmic conditions encountered in primary and secondary care. The World Health Organization estimated that in 2010 glaucoma accounted for 2% of visual impairment and 8% of global blindness. Disability adjusted life years Glaucoma : A Review *Seema Thakur, Neha Srivastava, Deepshikha Patle Faculty of Pharmaceutical Sciences, PCTE Group of Institutes Ludhiana Correspondaning author : thakurseema1983@yahoo.co.in