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Year : 1991  |  Volume : 39  |  Issue : 3  |  Page : 84


Dept. of Opthamology, CBM Ophthalmic Institute, Angamally, Kerala- 683 572, India

Correspondence Address:
T P Ittyerah
Dept. of Opthamology, CBM Ophthalmic Institute, Angamally, Kerala- 683 572
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Source of Support: None, Conflict of Interest: None

PMID: 1841896

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How to cite this article:
Ittyerah T P. Glaucoma. Indian J Ophthalmol 1991;39:84

How to cite this URL:
Ittyerah T P. Glaucoma. Indian J Ophthalmol [serial online] 1991 [cited 2022 Jun 29];39:84. Available from: https://www.ijo.in/text.asp?1991/39/3/84/24444

Early diagnosis and management of glaucoma was always tricky and often difficult. In the past we had several occasions where glaucoma was missed, and even today chronic simple glaucoma often escapes the "cataract conscious" eyes of the ophthalmologist. The new techniques developed in early diagnosis of glaucoma, especially chronic simple glaucoma are fascinating and rewarding. The red free filter fundus examinations for the study of nerve fibre layers is not difficult for an average ophthalmologist with some experience.

Once a patient is diagnosed as having glaucoma and starts getting medical treatment or has undergone glaucoma surgery, he or she is branded as a glaucoma patient for ever. Even if the original diagnosis was wrong it is extremely difficult to prove it and they remain as glaucoma patients throughout their life. So it is better to confirm the diagnosis of glaucoma before starting therapy for the same, especially in border line cases. Once upon a time eye surgeons were reluctant to operate for glaucoma since the prognosis was not as good as that of cataract. Now the trend is changing and once the optimum medical therapy fails, surgery is performed in most 'of the centres. Certain centres try LASER trabeculoplasty before surgical interference. The use of LASER for iridectomy further widens the scope for non-invasive management of glaucoma.

Whereas in Western countries the decision forsurgical intervention is based on medical grounds alone, in developing countries such as ours, socio-economical considerations play a large role, since modern medical therapy is very expensive. Besides this, illiteracy and ignorance may lead to drop outs from the glaucoma follow up clinics. The surgery for glaucoma has changed a lot from the original Elliot's trephining developed in Madras. The transformation from trephining through iridencleisis, Schie's trabeculectomy and trabeculo+o ny is really interesting. The use of 5-Fluroracil (5-FU) to prevent unwanted scaring of the drainage area is an additional tool in the hands of glaucoma surgeons. Even though new inve itions have increased the "Sight expectancy" of the glaucoma patient, they have invited new complications and side effects. One has to evaluate each technique and use it judiciously.


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