Glaucoma is the disease of the eye where the optic nerve gets damaged due to fluctuations in the pressure of the eye. Optic nerve is the connection between the eye and the brain and is the structure responsible for transmitting the electrical signals. There is constant water production inside the eye called as ‘Aqueous humor’ by the structures called as “Ciliary processes”.

This water gets drained out of the eye through the structure called as the “Angle”. When there is an imbalance between the production and the drainage, there is a fluctuation in the pressure of the eye.

glaucoma Bhalanetra eyecare hospital mumbai


  • What are the Different Types of Glaucoma
  • What are the symptoms of Glaucoma
  • What are the tests for Glaucoma
  • How do we treat Glaucoma


1.Use caution when evaluating “in-network” physicians. Despite what’s stated in your health insurance’s marketing materials, don’t assume in-network physicians provide better quality care. Currently there isn’t a tried-and-true, scientifically sound method for rating the quality of physicians. Any insurance company that suggests physicians participating in its own network provide better quality care is painting an inaccurate picture.

2.Ask those you trust. Good sources of information include your internist, optometrist, and friends who have had glaucoma surgery. Even better sources are the operating room nurses and staff at your local hospital. They are often in surgery with eye doctors and know who has the “best hands.” Nurses are by nature very helpful people and will often be happy to answer your questions. The challenge will be getting past the hospital’s automated telephone menu and gaining access to a live operating room nurse. I would suggest calling the hospital’s main number in the morning. Choose the option for a live operator. Once you have a live person ask to be transferred to the Operating Room Nursing Station. A nurse will often pick up once the line is transferred.

3.Research your surgeon’s education. Where did your eye surgeon train? It’s fairly easy to check the ratings for various training programs. Two objective resources are U.S. News & World Report’s annual rating of Medical Schools and Eye Hospitals, both of which can be found online. Don’t get too hung up on the ranking order. If your surgeon trained at a Top 15 institution, he or she received a top-notch education. Four, research your surgeon’s state licensure. Make sure your surgeon is licensed to practice medicine in your state. Go to your state medical board’s Web site and do an online search. In addition to confirming a surgeon’s licensure, many state license Web sites will also tell you whether there has been any disciplinary or legal action taken against your surgeon.

4 Research your surgeon’s state licensure. Make sure your surgeon is licensed to practice medicine in your state. Go to your state medical board website and do an online search. In addition to confirming your surgeon’s state licensure, many state license websites will also tell you whether there has been any disciplinary or legal action against your surgeon.

5 Confirm that your surgeon is board certified. When a physician becomes board certified, it guarantees he or she has met minimum competency requirements. In order to become certified, an eye surgeon must successfully pass both a written and oral examination. Additionally, younger surgeons must re-certify every ten years.

6 Visit your surgeon’s Web site. You can often obtain very useful information from your eye surgeon’s Web site. However, keep in mind that the primary goal of most web sites is to market the practice. You won’t find anything negative about your doctor there, but it can give you more insight into the surgeon’s background and practice philosophy.

7 Find out what others have experienced. Are testimonials from satisfied patients available on your surgeon’s web site or physician-ranking Web sites? Can you review testimonials in your surgeon’s office? Will your surgeon provide the names and phone numbers of patients who have offered to act as references? It shouldn’t be too hard for your surgeon to come up with a list of people willing to discuss their glaucoma surgery experience with you. Keep in mind that federal privacy regulations limit the amount of information a surgeon may be able to offer regarding other patients who have had surgery.

8 Find out how many eye surgeries your doctor has performed. There is a reason they call it the “practice of medicine.” Just like a sports pro, a surgeon’s abilities improve with practice and experience. Every surgeon requires a minimum number of “cases” to become proficient. For glaucoma Laser surgery, this number is probably around 500 but to be safe, choose a surgeon who has performed at least a thousand procedures. How do you find out the number of eye surgeries your surgeon has performed? Just Ask. If you are uncomfortable asking this question, then bring to your appointment someone to ask for you. This is a very important question. These are your eyes. You only have two. Get over your hesitation. Just ask.

9 Meet your Surgeon. One of the most important criteria for choosing your surgeon is your ability to trust him or her meet with your surgeon. Make sure you feel comfortable with what your surgeon says and with the level of care. Trust is an important consideration that cannot be sufficiently developed until you talk with your surgeon face to face.

10 Finally, get a second opinion. Most people wouldn’t purchase a car without test driving at least one other car. Glaucoma Laser surgery is a very important decision and getting a second opinion is a smart idea many people are uneasy about getting a second opinion but a second opinion is a common medical practice encouraged by the best surgeons. In fact, one quick test of your surgeon’s comfort with his or her own abilities is to let him know that you’ll be getting a second opinion. If the surgeon becomes defensive about this, then you’ll know a second opinion was a good idea after all. Unless you are completely comfortable with your surgeon, get a second opinion. I would, of course, be pleased if you select me as your surgeon and would be happy to offer a second opinion- even if you don’t choose me.

Open Angle Glaucoma:

This is currently the most common type of glaucoma seen and noted in the Indian population. It usually results from clogging or partial closure of the drainage channel. Hence the amount of water (Aqueous humor) exceeds the amount getting drained. This causes a rise in the pressure of the eye.

Closed angle glaucoma:

In this kind of glaucoma the drainage channel remains patent but the walls around it prevent the water inside the eye from reaching it. These walls are formed by the Iris (The layer which gives colour to the eye) and the Cornea (the outermost layer of the eye). Due to the constricted space the water drainage is hampered and the pressure inside the eye rises. This kind of glaucoma requires early detection and intervention to prevent an “Eye attack” (Acute angle closure glaucoma). Eye attack is a condition where the pressure inside the eye suddenly raises many fold and may result in permanent blindness. Bhalanetra superspeciality eye hospital is equipped with sophisticated instruments to detect this condition earlier.

Normal tension glaucoma:

This is a poorly understood condition and is being researched upon. In this kind of glaucoma the pressures and all the structures in the eye remain normal. In spite of that the disease progresses. This form of Glaucoma requires serial pressure monitoring and serial perimetry to detect the progression of glaucoma. Such a glaucoma can progress faster and cause irreversible damage if not detected in time.

Congenital glaucoma:

This is a form of glaucoma where the disease is present since birth. The child is born with megalocornea (large eyes). Due to soft eyes the increased pressure in the eyes balloons up the eye ball increasing the eye size. There is a failure of the trabecular meshwork (Drainage channel) to develop. This condition is an emergency condition and requires urgent intervention. Immediate surgery is the only way to save the eye and the vision.

Secondary glaucoma:

This form of glaucoma develops after certain eye conditions and diseases. Uveitis, Retina surgeries, complicated cataract surgery can result in irreversible damage to the trabecular meshwork. This causes the hampering of the drainage of the water. These glaucomas are difficult to handle and require surgery invariably. Glaucoma surgeries require expertise and we at Bhalanetra superspeciality eye hospital proudly boast of the availability of these services and expertise.

Other types of Glaucoma are Pseudoexfoliative glaucoma, pigment dispersion glaucoma, steroid induced glaucoma, Phacolytic and Phacomorphic glaucoma (Glaucoma due to cataract). These types are can be caused by a various factors and need specialized care.

Apart from angle closure glaucoma rest all glaucomas are very silent and don’t present with any symptoms unless the glaucoma has progressed. Glaucoma causes reduction in the quantity of vision rather than the quality of the vision. It basically starts to reduce the peripheral field of vision.

Acute angle closure glaucoma presents with pain, redness, blurring of vision, headache, vomiting, dizziness.

Other more common forms of glaucoma just present with mild disturbance of vision. The patients usually complain of night blindness and difficulty in finding things in low light. Patient may bump into things in low light conditions. Patient may never realize that he/she has glaucoma till the last stage.

Glaucoma requires monitoring of the following ways:

Structural monitoring:

This requires OCT (Ct Scan of the eye using light) of the RNFL (Light sensing structure of the eye) and optic disc (The connecting wire between the eye and the brain). This test maybe used for diagnosis and as well as the prognosis.


This test measures the quantity of vision in the eye. This is the only test which can measure the amount of damage to the eye due to glaucoma. Serial perimetry shall be required to get an exact measurement of the amount of vision remaining in the eye. This tests the function of the RNFL and hence gives us the amount of remaining viable RNFL.


This is measurement of the pressure of the eye. The pressure of the eye is a dynamic component. It keeps on changing throughout the day. Hence a single pressure measurement shall not give us a correct picture. Applanation tonometry remains the gold standard way of measuring the eye pressure. All other forms are compared against this form of measurement. Bhalanetra superspeciality eye hospital is equipped with this tonometer.


This is the measurement of the amount of space between the iris and the cornea to judge whether the space is adequate or not for the drainage of the water of the eye.

  • Medically
  • Laser
  • Surgically

Medical treatment:

Glaucoma can be controlled with Eye drops. These drops either reduce the water production in the eye or increase the drainage or both. These medications come with their own set of complications and hence require specialized evaluation. The eye surgeon shall evaluate your eye condition and the type of glaucoma to judge the eye drops that shall be suitable for you.


Lasers can be used to either increase the space between the iris and the cornea or to create a bypass route for the water to flow. These lasers have shown some kind success in advanced glaucomas and are of benefit in reducing the number of medications in early glaucomas.


Surgery remains the main modality of treatment to dampen the pressure fluctuations permanently. Trabeculectomy remains the mainstay treatment and chief surgeon of the Bhalanetra superspeciality eye hospital is trained well in the art of performing this surgery. Other advanced form of glaucoma surgery viz: Ahmed glaucoma valve is also available as a form of treatment in our hospital.

The Chief Medical Director and Eye Surgeon of Bhalanetra Superspeciality Eye Hospital is a Glaucoma Specialist.

To know more details about Glaucoma, Please call us on +91 9833976577

Disclaimer: The services mentioned and Photographs used are for representational and education purpose. The actual procedure & Result may vary from patient to patient. For more details on the topics and treatment plan, please consult with our experts at Bhalanetra Superspeciality Eye Hospital to know more.