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Glaucoma: Know the types, symptoms, risk factors and how to manage the condition

The Kashmir Monitor

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Glaucoma or ‘Kala Motia’ is a condition wherein an increased intraocular pressure damages the optic nerve, thereby affecting vision. In the normal eye, the rate of production of aqueous (the fluid that nourishes the front part of the eye) matches the rate of its drainage, thereby maintaining optimal pressure inside the eye. However, with age, disease, trauma or other factors, the channels carrying this fluid may get blocked, increasing the pressure inside the eye.

This increased pressure damages the optic nerve, which is the conduit of visual messages to the brain. Working silently, glaucoma damages the outer or peripheral vision first while maintaining the central vision, says Dr Mahipal S. Sachdev, chairman, Centre for Sight.

Glaucoma is called the silent thief of sight because there may be no symptoms in the early stages of the disease. This condition threatens vision and is known to gradually steal sight without warning. By the time glaucoma is detected, the patient has already suffered extensive peripheral vision damage which can no longer be restored.

 

It is the leading cause of blindness in the United States, and a study presented at the World Ophthalmological Congress in 2008 projected India as the next glaucoma capital. Almost 68 per cent Indians run the risk of developing the disease, and nearly 1.2 lakh Indians go blind every year due to this disease.

Below, Dr Sachdev shares the risk factors, symptoms and ways to manage the condition.

You are at risk, if:

*You are 45 years of age or above

*You have a family history of glaucoma

*You have health problems such as diabetes, hypertension or thyroid disease

*You suffer from myopia or nearsightedness

*You have had ocular trauma or intra ocular surgery in the past

Types of glaucoma:

There are two major types of glaucoma

*Chronic or Primary Open-Angle Glaucoma (POAG): The chronic open angle form of glaucoma is the most common form. Damage to vision is gradual and generally painless.

*Closed or Acute Angle-Closure Glaucoma : In the closed or acute form, the intraocular pressure increases rapidly due to a sudden and severe block of fluid drainage within the eye. Significant symptoms indicating the presence of acute glaucoma appear immediately. This condition has to be treated quickly by an ophthalmologist otherwise blindness may occur.

Symptoms:

*Inability to adjust the eyes to darkened rooms, such as theaters

*Poor night vision

*Frequent changes in eyeglass prescription

*Gradual loss of peripheral vision

*Blurred vision

*Feeling of a blind area in the eye

*Seeing rainbow coloured halos around lights

*Severe eye pain, facial pain, nausea and vomiting

*Red eye

Cure

Glaucoma cannot be cured, but it can be controlled so that further damage to the optic nerve can be slowed down or halted. This can only be done through disciplined and regular treatment. The treatment of glaucoma is life-long.

Management of Glaucoma

Glaucoma treatment may include medical management, surgical management or management by lasers. Medical management is using eye drops. Surgical management includes a procedure where an opening is made to create a new drainage pathway for the fluid to leave the eye easily. Management by lasers includes procedures such as trabeculoplasty, in which a laser is used to pull open the trabecular meshwork drainage area; iridotomy, in which a tiny hole is made in the iris, allowing the fluid to flow more freely; and cyclophotocoagulation, in which a laser beam treats areas of the ciliary body, reducing the production of fluid.

Ways to treat

There is no proven way to prevent glaucoma. Frequent monitoring, regular checkups can help detect the disease in its early stages.

*Take your medicines exactly as prescribed. Use the right drop in the correct eye at the right time in the right way.

*Try to schedule the time for taking medication around daily routines such as waking, mealtimes and bedtime.

*Drinking large quantities of water on empty stomach early morning should be stopped. This habit temporarily increases the Intra Ocular pressure.


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Health

Hepatitis A Causes and Symptoms

The Kashmir Monitor

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Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:

 

Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.

Symptoms

Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Headaches
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Health

Busting myths around blood donation

The Kashmir Monitor

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As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.

 

The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Health

Erectile dysfunction’s connection with lifestyle

The Kashmir Monitor

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By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.

 

DIAGNOSIS OF ED

We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.

SHORT-TERM SOLUTION, LONG-TERM CURE

Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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