Patient Education
Article Index
Patient Education
Refractive errors
Strabismus/squint
Ambylopia
Diabetic Retinopathy
Age-related Macular Degeneration
Retinal Detachment
Allergic conjunctivitis
Trachoma
Pterygium
Glaucoma
All Pages

Cataract

What is Cataract?

patient1Normally, the lens of the eye is clear and allows light rays to pass through easily. When a cataract develops, the lens becomes cloudy and opaque. The light rays no longer pass through the lens easily, so the patient cannot see clearly.

A change in the chemical composition of the lens causes most cataracts. The following are the various types of cataracts.
There are many types of cataracts.

Age related cataract

This is the most common type of cataract, comprising 80 percent of the total cataracts. It occurs in patients above the age of 50.

Congenital Cataract

Cataracts in children are rare. They can be caused by infection of the mother during pregnancy, or they may be hereditary.

Traumatic Cataract

Eye injuries may cause cataracts in patients of any age.

Secondary Cataract

Eye diseases, like glaucoma, inflammations and infections inside the eye and eye tumors may cause cataracts.

Metabolic Cataract

Cataract is also caused by metabolic disorders like diabetes. Diabetic patients are more prone to develop cataract than their age-related compatriots.

Drug-induced Cataract

Prolonged treatment with steroid drugs, either for local (e.g., allergic conjunctivitis) or systemic diseases (e.g., asthma) may lead to cataract formation.

Symptoms of Cataract patient2

• Blurring or dimness of vision
• Feeling of a film over the eyes
• Sensitivity to light and glare
• Change in colour of pupil
• Double vision and dulling of colour sense

Treatment

Cataract cannot be cured by medicines or spectacles. Removal of the clouded lens through surgery is the only treatment.

Types of Cataract Removal

Routine method (old method) -

After administering a local anesthesia, a 10 mm incision is made in the eye. The cataract lens is removed and it may be replaced by an Aphakic glass. The incision is then closed with sutures. After the surgery, glasses with high power called aphakic spectacles are prescribed to the operated person. The disadvantages of this type of surgery is that the aphakic glasses are heavy, images seen are larger than they normally appear to be, and the field of vision is restricted.

New method (IOL) - Implanting of Intraocular lens (IOL) with sutures:

After administering a local anaesthesia, a 10 mm incision is made in the eye. The clouded lens is removed and replaced by an IOL and the incision is then closed with sutures. The entire procedure takes only 15 minutes.

What is IOL?

patient3Intra Ocular lens (IOL) is a tiny transparent convex lens. It is made of polymethyl methacrylate , (a harmless plastic substance). Unlike contact lens, an IOL stays permanently in the eye and does not cause irritation.

Advantages of IOL

• Since the lens is placed inside the eye, most often the patient need not wear glasses for clear vision. But sometimes patient has to wear glasses for clarity.
• Images are clear and of the same dimension without distortion
• Full vision returns very clearly
• Normal field of vision

Phaco or suture-less surgery with implantation of IOL

After giving a local anaesthesia, a 5mm incision is made in the eye. The cataract lens is broken into small pieces by a machine with ultrasonic waves and removed with a needle.
A specially prepared IOL is inserted into the eye through the small incision and the wound heals without sutures.

Advantages of Phaco

• Small Incision
• No sutures and no need of suture removal.
• No irritation, no watering
• Early return to work
• No need to continue drops for a long time
• Stable refraction after one monthtest


Refractive errors

In normal vision, light rays from an object focus on the retina (emmetropia). Alternatively, in the presence of a refractive error, the light rays get focused in front or behind the retina causing blurred vision. Under normal conditions, as the eye ball grows in size from infancy to adulthood, there will be a corresponding change in curvature of cornea and the lens enabling the eye to remain emmetropic, at all ages.
When one of these fails to happen, refractive error occurs: patient4
• The eye ball being larger or smaller than the normal size
• The corneal curvature being flatter or steeper than usual
• Increase or decrease in the power of the lens
These refractive errors can be classified as myopia (near sightedness) and hyperopia (far sightedness), astigmatism and presbyopia

What is hyperopia ?

In hyperopia or far sightedness, the light rays from an object form an image behind the retina.
Children with hyperopia
• Find difficulty in reading, writing and looking at both near and distant objects.
• Eye strain while trying to read for long hours
• May have squint (crossed eyes)

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What is myopia?

In myopia or near sightedness, the light rays from an object form an image in front of the retina.
Children with myopia
• Have defective vision for distance and clear vision for near
• Squeeze their eyes while trying to see distant objects
• Hold books close to their face while reading

What is astigmatism?

• Astigmatism is a condition in which objects, both near and distant, appear blurred. The cornea and lens of the eye should be spherical. When one or both are curved more steeply in one meridian than another, the optics take on a toric shape.
• This uneven curvature prevents light rays entering the eye from focusing to a single point on the retina.
• Astigmatism often occurs in combination with myopia and hyperopia.
• Astigmatism is corrected with glasses or contact lenses.

What is presbyopia?

• After 40 years of age, most people find it increasingly difficult to read or see clearly at close range.
• This condition is a normal part of aging and is called presbyopia often referred to as farsightedness.
• Presbyopia develops as the lens of the eye becomes less flexible and loses its ability to focus on near objects.
• Presbyopia is treated with reading glasses which can be single vision, bifocals or progressive lenses.

Treatment of refractive errors

• Corrective spectacle is the best option available.
• The power of the glasses may change depending on the growth of the eye ball. An eye check-up and change of glasses if necessary, has to be done once in 6 months for children under 5 years of age and once a year thereafter. Failure to wear glasses in childhood when needed will retard the development of vision in that eye.
• Children older than 15 years can use contact lenses if they don’t want spectacles.
• Those over 20 years of age with stable refraction also have the option of LASIK, a laser refractive surgery.


Strabismus/squint

Squint is misalignment of the eyes such that the right and left eyes are pointed in different directions. Though it is a common condition among younger populations, affecting 2 to 4 percent of children, it may also appear later in life.
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The misalignment may be permanent or it may be temporary, occurring occasionally. The deviation may be in any direction: inward, outward, upward or downward.

Causes

• Weakened muscles or abnormal nerve impulses to the eye muscles
• Heredity
• Blurred or poor vision
• Pathology inside the eye, such as cataract
• Staring into bright light during early childhood is not a cause

Signs and Symptoms

The primary sign of squint is an eye that is not straight. Sometimes, a youngster will squint or close one eye in bright sunlight. Faulty depth perception may be present. Some children turn their faces or tilt their heads in a specific direction in order to use their eyes together.

Treatment

Parents often get the false impression that a child may "outgrow" the problem. If a child's two eyes are pointed in different directions, examination by an ophthalmologist is necessary to determine the cause and to begin treatment.

The goals of treatment are to preserve vision, straighten the eyes and to restore binocular vision. Treatment of squint depends upon the exact cause of the misaligned eyes. It can be directed towards unbalanced muscles or other conditions which are causing the eyes to point in two different directions. After a complete eye examination, including a detailed study of the inner parts of the eye, an ophthalmologist can recommend appropriate optical, medical or surgical therapy.

Non surgical treatment - spectacles

Some squints are caused by refractive errors. In such cases, squint can be corrected by prescribing proper spectacles.

Surgical treatment

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Most patients require surgical correction. Surgery is done under general anesthesia in children and under local anesthesia in cooperating adults. To undergo general anesthesia the child should be free from acute illness.


Ambylopia

What is amblyopia ?

Amblyopia is reduced vision in an anatomically normal eye. The term "lazy eye" is used to describe it. Children under 9 years of age whose vision is still developing are at the highest risk for amblyopia. Generally, the younger the child is, greater is the risk.

When does amblypia develop ?

Amblyopia develops when any of the following conditions occur:
o Squint/Strabismus (eyes not positioned straight)
o There is a difference in power between the two eyes (one eye focuses differently from the other)
o Cataract (clouding of the lens)
o High or moderate power in both eyes
o Severe ptosis (droopy eyelids)

Why does amblyopia develop?

Amblyopia develops because when one eye is turned, as in squint, two different pictures are sent to the brain. In a young child, the brain learns to ignore the image of the deviated eye and see only the image of the better eye. Similarly when there is difference in power between the two eyes, the blurred image formed by the eye with greater power is avoided by the brain. In order that the retina may capture an object, it needs adequate light and visual stimulus. When these factors are absent, as in the presence of cataract, amblyopia results. A moderate or high degree of refractive power present in both eyes, when not corrected early and adequately, also results in amblyopia.

What should be done?

Amblyopia can often be reversed if it is detected and treated early. Cooperation of the patient and parents is required to achieve good results. If left untreated or if not treated properly, the reduced vision or amblyopia becomes permanent and vision cannot be improved by any means.

How is amblyopia treated?

The most effective way of treating amblyopia is to make the child use the amblyopic eye. Covering or patching the good eye to force the use of the amblyopic eye may be necessary to ensure equal and normal vision. This can be achieved by:
• prescribing proper spectacles if the patient is found to have refractive error
• removal of cataract when indicated
• occluding the normal eye
• Surgery, when amblyopia is accompanied by strabismus


Diabetic Retinopathy

• Diabetics are twice as likely as non-diabetics to develop eye problems. The most common eye complication in diabetes is diabetic retinopathy; other complications are cataract and glaucoma.
• Fifty percent of diabetics develop some degree of diabetic eye disease.
• The risk of blindness is 25 times higher in diabetics than in non-diabetics.
• Early detection and timely treatment of diabetic eye disease significantly reduces the risk of vision loss.
• Diabetic retinopathy is often symptom-less in the early stages. Since only an ophthalmologist can detect early signs of diabetic retinopathy, all diabetics should have their eyes examined at least once every year.

How does diabetes affect the eye?

Diabetes causes weakening of the blood vessels in the body. The tiny, delicate retinal blood vessels are particularly susceptible. This deterioration of retinal blood vessels, accompanied by structural changes in the retina, is termed diabetic retinopathy and will lead to loss of vision.

Diabetic retinopathy is gradual in onset and is related to the duration of diabetes. High blood glucose levels, high blood pressure and genetics influence the development and progression of diabetic retinopathy.

There are two main stages of diabetic retinopathy:
Non-proliferative: When the blood vessels leak, macular edema may occur, thereby reducing vision.
patient8patient9
• Proliferative: When new, weak blood vessels grow or proliferate, bleeding into the vitreous may occur and cause severe visual loss.
patient10patient11

Eye examination in diabetic retinopathy

Every diabetic is a potential candidate for diabetic retinopathy. There are no symptoms at the initial stages. Periodic eye examination with dilated pupils is the only way to detect early disease and prevent further deterioration of vision.

Diagnosis

Diagnostic tools such as a slit lamp, ultrasound and procedures such as fluorescein angiography are used in addition to an ophthalmoscope to assess whether the patient has diabetic retinopathy or other eye problems.

Fluorescein Angiography

This is a magnified photography of the retina using an injectable dye. It helps classify the condition, record changes in the retinal blood vessels, decide on the mode of treatment and evaluate the treatment.

Treatment

Lasers are widely used in treating diabetic retinopathy. Lasers are formed by an intense and highly energetic beam of light. They can slow down or stop the progression of diabetic retinopathy and stabilise vision.
The laser experience
Laser treatment is usually performed as an outpatient procedure. The patient is given topical anaesthesia to prevent any discomfort and is then positioned before a slit lamp. The ophthalmologist directs the laser beam precisely on the target with the aid of the slit lamp and a special contact lens. Absorption by the diseased tissue either seals or destroys the tissue. Additional treatment may be required according to the patient's condition.

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An eye after laser treatment

Side effects

Some patients may experience side effects after laser treatment. These are usually temporary. Possible side effects include watering eyes, mild headache, double vision, glare or blurred vision. In the event of sudden pain or vision loss, the ophthalmologist must be contacted immediately.

Vitrectomy

In some patients, there may be bleeding into the vitreous or the vitreous may pull the retina, reducing vision severely. In such instances a surgical procedure called vitrectomy (replacing the vitreous by a clear artificial solution) is performed. Vitrectomy is done only after other forms of treatment have been unsuccessful. Vitrectomy is a very complex and expensive surgery. Thus, diabetic retinopathy should be detected early and treated with laser.


Age-related Macular Degeneration

patient13Age-related macular degeneration (AMD) is a disorder of the macula, the small, central portion of the retina that processes the sharp, "straight ahead" vision needed for reading, driving a car or recognizing faces. AMD does not cause total blindness because the remaining or undamaged parts of the retina around the macula continue to provide peripheral or "side" vision. AMD is more common in people over 60 and often runs in families.

There are two common types of macular degeneration. The more common "dry" form is associated with the aging and thinning of the tissues of the macula. It develops slowly and usually causes mild vision loss. The "wet" form accounts for 20% of AMD cases but poses a greater threat to vision. In these cases, abnormal blood vessels grow beneath the retina where they leak fluid and blood. If severe, this can create a large blind spot in the center of vision, resulting in the loss of all "straight ahead" vision.

patient14patient15

Signs and Symptoms

Blurry or fuzzy vision; distortion of straight lines, such as sentences on a page, telephone poles, and sides of buildings; a dark or empty area in the center of vision

Treatment

Intraocular anti-VEGF injection therapies have revolutionized the treatment of wet age-related macular degeneration. Wet macular degeneration is the result of the formation of new, fragile and leaky blood vessels growing under the retina, damaging the rod and cone cells. The anti-VEGF drugs, which are injected into the eye with a fine needle, inhibit the growth of these leaky blood vessels and improve vision for patients with wet age-related macular degeneration.
Avastin and Lucentis are the two most commonly used anti-VEGF drugs.
So far there is no treatment for the dry type of macular degeneration.
Patients who have macular degeneration in one eye or early signs of macular degeneration can benefit from the following measures:

  • Monitor your vision daily. By checking your vision regularly, changes that may require treatment can be detected early.
  • Take a multi-vitamin with zinc. (check with your eye doctor for a recommendation). Antioxidants, along with zinc and lutein are essential nutrients, all found in the retina. It is believed that people with macular degeneration may be deficient in these nutrients.
  • Incorporate dark leafy green vegetables into your diet.
  • Always protect your eyes with sunglasses that have UV protection. Ultraviolet rays are believed to cause damage to the pigment cells in the retina.
  • Quit smoking. Smoking impairs the body’s circulation, decreasing the efficiency of the retinal blood vessels.
  • Exercise regularly. Cardiovascular exercise improves the body’s overall health and increases the efficiency of the circulatory system.

Retinal Detachment

patient16patient17
A retinal detachment is a separation of the retina from its attachments to the underlying tissue within the eye. Most retinal detachments are a result of a retinal break, hole, or tear. These retinal breaks may occur when the vitreous gel pulls loose or separates from its attachment to the retina, usually in the peripheral parts of the retina.
The vitreous is a clear gel that fills two-thirds of the inside of the eye and occupies the space in front of the retina. As the vitreous gel pulls loose, it will sometimes exert traction on the retina, and if the retina is weak, the retina will tear. Most retinal breaks are not a result of injury. Many people develop separation of the vitreous from the retina as they get older. However, only a small percentage of these vitreous separations result in retinal tears.
Once the retina has torn, liquid from the vitreous gel can then pass through the tear and accumulate behind the retina. The buildup of fluid behind the retina is what separates (detaches) the retina from the back of the eye. As more of the liquid vitreous collects behind the retina, the extent of the retinal detachment can progress and involve the entire retina, leading to a total retinal detachment. A retinal detachment almost always affects only one eye at a time. The second eye, however, must be checked thoroughly for any signs of predisposing factors that may lead to detachment in the future.

What are retinal detachment symptoms and signs?

Flashing lights and floaters may be the initial symptoms of a retinal detachment or of a retinal tear that precedes the detachment itself. Anyone who is beginning to experience these symptoms should see an eye doctor (ophthalmologist) for a retinal exam. In the exam, drops are used to dilate the patient's pupils to make a more detailed exam easier.
The flashing lights are caused by the vitreous gel pulling on the retina or a looseness of the vitreous, which allows the vitreous gel to bump against the retina. The lights are often described as resembling brief lightning streaks in the outside edges (periphery) of the eye. The floaters are caused by condensations (small solidifications) in the vitreous gel and frequently are described by patients as spots, strands, or little flies. Floaters are usually not associated with tears of the retina.
If the patient experiences a shadow or curtain that affects any part of the vision, this can indicate that a retinal tear has progressed to a detached retina. In this situation, one should immediately consult an eye doctor since time can be critical. The goal for the ophthalmologist is to make the diagnosis and treat the retinal tear or detachment before the central macular area of the retina detaches.

Which diseases of the eyes predispose to the development of a retinal detachment?

• Lattice degeneration of the retina is a type of thinning of the outside edges of the retina, which occurs in 6%-8% of the general population. The lattice degeneration, so-called because the thinned retina resembles the crisscross pattern of a lattice, often contains small holes. Lattice degeneration is more common in people with nearsightedness (myopia). This tendency to lattice degeneration occurs because myopic eyes are larger than normal eyes and, therefore, the peripheral retina is stretched more thinly. Fortunately, only about 1% of patients with lattice degeneration go on to develop a retinal detachment.
• High myopia (greater than 5 or 6 diopters of nearsightedness) increases the risk of a retinal detachment. In fact, the risk increases to 2.4% as compared to a 0.06% risk for a normal eye at 60 years of age. (Diopters are units of measurement that indicate the power of the lens to focus rays of light.) Cataract surgery or other operations of the eye can further increase this risk in those with high myopia.
• Cataract surgery, especially if the operation has complications, increases the risk of a retinal detachment.
• Trauma to the eye be it blunt or with sharp penetrating objects increases the risk for retinal detachment.
• Individuals with chronic inflammation of the eye (uveitis) are at increased risk of developing retinal detachment.

Treatment of retinal detachment

Laser treatment of retinal breaks

Retinal breaks without retinal detachment can be treated with laser or cryo (freezing machine) so that scar is formed around the break which will then be sealed before fluid gets back and detaches the retina.

Scleral Buckle Surgery for Retinal Detachments

Scleral buckle is a surgical procedure that has been used for more than 30 years. It involves the placement of silicone onto the outer wall of the eyeball to create a buckle effect inside the eye. The buckle pushes against the retinal tear or detachment, helping to push it back into a more normal position. Once the tear is sealed, the eye completes the healing process by resorbing the fluid inside the retina (the subretinal fluid).

Vitrectomy for Retinal Detachments

For certain types of retinal detachments ("traction" retinal detachments and detachments that involve the loss of the natural fluids inside the retina), vitrectomy is a commonly used surgical procedure.
Sometimes referred to as "pars plana vitrectomy or PPV," this procedure was developed about 20 years ago. Small incisions are made to allow access into the center of the eyeball. The surgeon removes the vitreous and repairs the detachment. After surgery, the patient will need to use certain precautions and maintain specific head positions to prevent another retinal detachment. Within days-to-weeks of surgery, the eye will replace its own fluids inside the retina.


Allergic conjunctivitis

Allergic conjunctivitis is inflammation of the tissue lining the eyelids (conjunctiva) due to a reaction from allergy-causing substances such as pollen and dander.

Causes

When your eyes are exposed to anything to which you are allergic, histamine is released and the blood vessels in the conjunctiva become swollen (the conjunctiva is the clear membrane that covers the "white" of the eye). Reddening of the eyes develops quickly and is accompanied by itching and tearing.
Allergies tend to run in families, although no obvious mode of inheritance is recognized. Keep in mind that rubbing the eyes makes the situation worse.

Symptoms

Symptoms may be seasonal and can include:
• Red eyes
• Dilated vessels in the clear tissue covering the white of the eye
• Intense itching or burning eyes
• Puffy eyelids, especially in the morning
• Tearing (watery eyes)
• Stringy eye discharge

Treatment

The best treatment is avoiding exposure to the cause or allergen. Unfortunately, this is not often practical. Discomfort can be relieved by applying cool compresses to the eyes or taking antihistamines by mouth (many of these are available over the counter).
If home-care measures do not help, treatment by the health care provider may be necessary. This may include:
• Antihistamine or anti-inflammatory drops that are placed into the eye
• Mild eye steroid preparations applied directly on the surface of the eye (for severe reactions)
• Eye drops that prevent certain white blood cells called mast cells from releasing histamine; these drops are given in combination with antihistamines for moderate to severe reactions


Trachoma

Trachoma is a bacterial infection of the eye.
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Causes, incidence, and risk factors

Trachoma is caused by infection with the bacteria Chlamydia trachomatis.
The condition occurs worldwide, mostly in rural settings in developing countries. It frequently affects children, although the effects of scarring may not be seen until later in life. Trachoma is spread through direct contact with infected eye, nose, or throat secretions or by contact with contaminated objects, such as towels or clothes. Flies play important role in spreading the bacteria.

Symptoms

Symptoms begin 5 to 12 days after being exposed to the bacteria. The condition begins slowly as inflammation of the tissue lining the eyelids (conjunctivitis, or "pink eye"), which if untreated may lead to scarring.
Symptoms may include:
• Cloudy cornea
• Discharge from the eye
• Swollen eyelids
• Turned-in eyelashes

Signs and tests

An eye exam may reveal scarring on the inside of the upper eye lid, redness of the white part of the eyes, and new blood vessel growth into the cornea.
Treatment
Antibiotics can prevent long-term complications if used early in the infection. Antibiotics include erythromycin and doxycycline. In certain cases, eyelid surgery may be needed to prevent long-term scarring, which can lead to blindness if not corrected.

Complications

If the eyelids are severely irritated, the eyelashes may turn in and rub against the cornea. This can cause eye ulcers, additional scars, vision loss, and possibly, blindness.

Prevention

The following simple measures play important role in controlling the transmission of trachoma and preventing blindness from trachoma:
Personal hygiene like face and hand washing
Environmental hygiene including the use of proper latrines
The proper use of cheap antibiotics like tetracycline
Simple eyelid surgery to correct misaligned eyelashes which rub on the cornea and cause blindness


Pterygium

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A pterygium is a non-cancerous growth of the clear, thin tissue (conjunctiva) that lays over the white part of the eye (sclera). One or both eyes may be involved.

Causes

The cause is unknown, but it is more common in people with excess outdoor exposure to sunlight and wind, such as those who work outdoors.
Risk factors are exposure to sunny, dusty, sandy, or windblown areas. Farmers, fishermen, and people living near the equator are often affected. Pterygium is rare in children.

Symptoms

The main symptom of a pterygium is a painless area of raised white tissue, with blood vessels on the inner or outer edge of the cornea. Sometimes it may become inflamed and cause burning, irritation, or a feeling like there's something foreign in the eye.

Treatment

No treatment is needed unless the pterygium begins to block vision or causes symptoms that are hard to control. Then it should be removed with surgery. Wear protective glasses and a hat with a brim to prevent the condition from returning.
Most pterygia cause no problems and do not need treatment. If a pterygium affects the cornea, results are usually good after it is removed.
A pterygium can return after it is removed.


Glaucoma

patient22Glaucoma is a condition wherein the pressure of fluid within the eye (intraocular pressure) gradually increases to a level not tolerated by the sensitive tissues of the eye. The optic nerve, which is similar to a cable wire carrying visual images to the brain, is the portion of the eye susceptible to damage from glaucoma. Such damage is irreparable and visual loss due to glaucoma is irreversible.

Causes of Glaucoma

There is a fluid filled chamber in the front of the eye called the anterior chamber. It is filled with aqueous humour, which bathes and nourishes the tissues of the eye. If the drainage of this fluid is restricted, for reasons yet unknown, pressure builds up within the eye causing glaucoma.

Who is likely to get Glaucoma ?

o Persons over the age of 40 are more likely to develop glaucoma. However, the disease may occur in people of all ages including newborns.
o Persons with myopia, diabetes, and family history of glaucoma have an increased risk.

Symptoms of Glaucoma

In most cases of glaucoma, the patient is not aware of the gradual loss of sight until vision is significantly impaired.

There are only a few types of glaucoma which present with sudden onset of pain and reduction of vision.

How is Glaucoma treated?

A simple test with a device called the tonometer measures pressure within the eye. This test alone cannot detect all glaucomas. The back of the eye should be inspected to view the optic nerve after dilating the pupils. Side vision may also be examined by a computer-assisted test called perimetry (visual field examination).

The loss of vision due to glaucoma is irreversible. However, appropriate treatment and regular follow-up can preserve residual vision.
The earlier the diagnosis, the better the chances of arresting visual impairment.

Medications

For most people with glaucoma, regular use of medications will control the increased fluid pressure. However, in some, drugs may stop working after a period of time. In these situations, the ophthalmologist can help by adding or changing medications or by choosing another type of treatment: laser or surgical methods. Periodical eye examinations are therefore essential to ensure that the medications are working.
Laser treatment
In some type of glaucomas, called angle closure glaucomas, laser treatment is the primary form of reducing the eye pressure. This is a simple out-patient procedure, which uses a strong beam of light to relieve the fluid pressure.
In open angle type glaucomas, laser treatment is applied only if various medications fail to control the fluid pressure. Medications need to be continued regularly even after laser treatment. Laser treatment has very minimal complications, but its effect in reducing the eye pressure may wear off over time.

Surgery

In some persons with glaucoma, medical or laser treatment is insufficient to arrest glaucoma and surgery is indicated. But this treatment option has its risks and limitations and is reserved as the treatment of last resort. Even after surgical treatment, individuals with glaucoma should continue periodical check-ups by an ophthalmologist and additional medications may be required indefinitely.

• Diabetic eye diseases
• Retinal detachment
• Macular degeneration
• Vitrectomy surgery
• Laser treatment