End stage glaucoma

The Glaucomatous disease process has a devastating effect on the eye structurally and functionally. When the disease progresses despite best measures to control the eye pressure with medications, Laser and surgery, the disease reaches end stage. This is characterised by certain characteristics such as severe drop in side- vision resulting in what is called as tunnel vision. The patient can have severe eye pain and headache due to high pressure. The raised eye pressure interferes with the normal function of the cornea- front portion of the eye, resulting in hazy/ opaque cornea which affects the vision. The optic nerve is damaged.

This can happen in any type of glaucoma and glaucoma due to any cause. Sometimes the damage is so severe, that the patient is blind.

The treatment depends on whether the patient has any useful vision or not. Accordingly, treatment options include placement of an artificial valve in the white part of the eye which can bypass the original drainage system which is severely damaged. If there is no useful vision, then treatment aims at reducing or stopping the aqueous- the fluid responsible for maintenance of eye pressure with the help of Laser ablation therapy. Sometimes, eye medications are required to maintain the eyeball from shrinkage and distortion of eye shape.