Glaucoma Treatment in Kolkata | Dr. Ananyabrata Das

Who should be checked

Everyone over 40, as part of a routine eye exam
Anyone with a parent or sibling who has glaucoma
People with diabetes, high blood pressure, or high myopia (minus power)
Anyone who has used steroid eye drops, inhalers, creams or tablets for long periods
Anyone who has had an eye injury

A Kolkata-specific warning: steroid eye drops are easy to buy over the counter for red, itchy eyes, especially during allergy season and conjunctivitis outbreaks. Used for weeks without supervision, they can raise eye pressure and cause glaucoma and cataract. If you have been using any drop for a long time, bring it to your appointment.

How glaucoma is diagnosed

Tonometry: measures the pressure inside the eye.
Optic nerve examination: the doctor looks at the nerve head through a dilated pupil.
OCT: a scan that measures the thickness of the nerve fibre layer, often showing damage before you'd notice.
Visual field test: you press a button when you see small lights. It maps your side vision.
Gonioscopy: checks whether the eye's drainage angle is open or narrow.
Pachymetry: corneal thickness, which affects how pressure readings are interpreted.

Open-angle and angle-closure

Open-angle glaucoma is the slow, silent kind. The drain is open but works poorly, and pressure creeps up over years.

Angle-closure glaucoma happens when the iris blocks the drain. It is more common in Asian eyes and in people with small, long-sighted eyes. It can build quietly, or strike suddenly.

Emergency: a suddenly painful red eye, blurred vision, coloured haloes around lights, headache, nausea or vomiting can be an acute angle-closure attack. Call immediately. This needs treatment within hours.

Treatment

Eye drops

Most people start with one drop a day. It lowers pressure and has to be used every day, for life, even when the eye feels perfectly normal. That is the hard part, and it is where most glaucoma treatment fails.

Laser

YAG peripheral iridotomy makes a tiny opening in the iris to stop angle closure. SLT (selective laser trabeculoplasty) improves drainage in open-angle glaucoma and can reduce or delay the need for drops. Both are done in a few minutes as OPD procedures.

Surgery

When drops and laser aren't enough, an operation such as trabeculectomy creates a new drainage route. In people who also have a cataract, combined surgery is sometimes the best option.

Getting drops right

Tilt your head back, pull the lower lid down, put one drop in the pocket. One is enough; the eye cannot hold more.
Close the eye and press gently on the inner corner for a minute. This keeps more drug in the eye and less in your bloodstream.
If you use two different drops, wait five minutes between them.
Set a phone alarm. Keep the bottle somewhere you'll see it.
Bring all your drops to every visit.

Questions

Can glaucoma be cured?

No, but it can almost always be controlled. Vision already lost cannot be restored, which is why early detection matters so much.

Will I go blind from glaucoma?

Most people who are diagnosed early and use their treatment keep useful vision for life. Blindness from glaucoma usually happens when it is found late or treatment is stopped.

Is high eye pressure the same as glaucoma?

Not exactly. Some people have high pressure without nerve damage (ocular hypertension) and are watched closely. Others have glaucoma with normal pressure. The diagnosis is made from the nerve and the field test together.

Does glaucoma run in families?

Yes. If a parent or sibling has it, your risk is several times higher. Get checked from your late thirties.

Glaucoma treatment in Kolkata: catching it before you notice it