Glaucoma destroys peripheral vision silently and permanently — often for years before patients notice anything is wrong. Dr. Swati Agarwal offers comprehensive glaucoma screening and management for patients in Kolkata and North Bengal.
Glaucoma is a group of conditions that damage the optic nerve — the cable connecting the eye to the brain. In most cases this is associated with elevated intraocular pressure (IOP), though normal-tension glaucoma also exists. The nerve fibres are destroyed progressively, beginning at the periphery and moving inward.
By the time a patient notices peripheral vision loss, they may have lost 40–50% of optic nerve fibres. Those fibres do not regenerate. This is why screening — before symptoms occur — is the only effective strategy.
Unlike cataracts, glaucomatous optic nerve damage cannot be reversed. Treatment halts progression — it does not restore lost vision. The earlier glaucoma is detected and treated, the more vision is preserved for life.
Most common type. Drainage angle appears open but drainage is impaired microscopically. IOP rises gradually. No symptoms until advanced. Requires long-term medical or laser management.
Emergency. Sudden severe eye pain, headache, nausea, rainbow halos, and blurred vision. IOP spikes dramatically. Requires same-day emergency treatment. Go to an eye casualty immediately if these symptoms develop.
Optic nerve damage occurs despite IOP within "normal" range. More common in women and East Asians. Requires the same management as high-pressure glaucoma — reducing IOP further than baseline.
Elevated IOP caused by another condition — diabetes, trauma, steroid use, uveitis, or previous eye surgery. Managed by addressing the underlying cause alongside IOP-lowering treatment.
If you have any of these risk factors and have not had a comprehensive glaucoma screening, please prioritise it. Annual screening from age 40 is recommended for everyone; from age 35 if family history is positive.
Non-contact "air puff" or Goldmann applanation tonometry. Note: a single normal reading does not rule out glaucoma — pressure fluctuates and normal-tension glaucoma exists.
Dilated slit-lamp biomicroscopy of the optic disc — the most important single test. Dr. Swati assesses the cup-to-disc ratio and looks for structural signs of glaucomatous damage.
Computerised mapping of the entire visual field. Glaucoma produces characteristic patterns of field loss — nasal step, arcuate scotoma — that confirm diagnosis and track progression.
A special lens allows direct visualisation of the drainage angle — distinguishing open from closed angle disease. Essential for treatment planning.
Thin corneas cause tonometers to underestimate true IOP. Pachymetry corrects for this and refines risk stratification.
Prostaglandin analogues, beta-blockers, and carbonic anhydrase inhibitors lower IOP through different mechanisms. Once-daily drops are the norm. Compliance is critical — the drops work only if used.
Selective Laser Trabeculoplasty — a painless in-clinic laser that improves drainage through the trabecular meshwork. May be used as first-line therapy instead of drops, or when drops are poorly tolerated. Effective, repeatable, no recovery time.
For angle-closure glaucoma: a small laser hole in the iris allows fluid to bypass the blockage. Highly effective and permanently protective against acute attacks. Performed in 5 minutes in the clinic.
Trabeculectomy and tube-shunt implantation for advanced glaucoma not controlled by drops or laser. Arranged with an experienced glaucoma surgeon at a referral centre where indicated.
Book a comprehensive glaucoma screening at The Eye Clinic. If you're over 40 or have a family history, this could be the most important eye appointment you ever make.