Tag: Glaucoma

If you are getting bored!

Bono has glaucoma!!

http://www.reuters.com/video/2014/10/17/u2s-bono-says-glaucoma-is-reason-for-tra?videoId=346616623

Whoopi Goldberg has glaucoma!!!

http://t.today.com/health/whoopi-goldberg-touts-vape-pen-debut-column-marijuana-1D79549417

 

Musician Ray Charles was born with congenital glaucoma.  He did not receive treatment which resulted in blindness by the age of 7.  He taught himself to ride a bike, play cards, and even fly a plane!  And of course, no one plays the piano quite like him..or the heartstrings

 

John Glenn, the oldest man in space, has glaucoma, and is an active crusader against the disease.

http://www.napsnet.com/pdf_archive/62/52627.pdf

Andrea Bocelli has had congenital glaucoma, even though that is not the reason for his blindness. He lost his vision in a soccer injury, that resulted in a brain hemorhhage.

http://www.telegraph.co.uk/culture/music/music-news/8100281/Doctors-tried-to-cure-Andrea-Bocellis-blindness-with-leeches.html

 

Dr Shibal Bhartiya- Glaucoma Specialist in Gurgaon

Dr Shibal Bhartiya — Glaucoma Specialist in Gurgaon

Glaucoma surgery

Dr. Shibal Bhartiya: Expert Glaucoma Specialist & Clinician-Scientist

Dr. Shibal Bhartiya is a globally recognized authority in Glaucoma and Neuro-Ophthalmology, currently serving as the Clinical Director at Marengo Asia Hospitals, Gurgaon. She is also a Research Collaborator with Mayo Clinic, Jacksonville, USA. Former Senior Scientific Research Fellow (Glaucoma)  University of Geneva, Switzerland & Former Senior Research Associate (Glaucoma + Cornea), AIIMS, New Delhi. 

With over 27 years of experience, she is one of the few specialists in India who seamlessly bridges the gap between high-volume clinical excellence and international medical research.

At a Glance

🎓 Fellowship trained — University of Geneva, Switzerland & AIIMS New Delhi
🔬 Research Collaborator — Mayo Clinic, Jacksonville, USA 
📚 200+ peer-reviewed publications · 20+ edited textbooks on glaucoma
🏆 Best Research Paper Awards — Asia Pacific Academy of Ophthalmology, Asia Pacific Glaucoma Congress, International Society of Glaucoma Surgery
🏥 Clinical Director, Ophthalmology — Marengo Asia Hospitals, Gurgaon

Academic & Research Distinction

As a Research Collaborator with the Mayo Clinic (Jacksonville, USA), Dr. Bhartiya is at the forefront of global innovations in eye care. Her academic journey includes a prestigious Clinical Research Fellowship in Glaucoma from the University of Geneva, Switzerland, and extensive training at AIIMS, New Delhi.

She is a prolific author of 28 medical textbooks and has published over 200 peer-reviewed research papers in international journals. Her leadership in the field is further cemented as the Executive Editor of the Journal of Current Glaucoma Practice and her role on the Associate Advisory Committee of the International Society of Glaucoma Surgery (ISGS).

Her work can be accessed on Pubmed, Google Scholar, ResearchGate and ORCID.

Patient-Centric Excellence

Beyond her academic accolades, Dr. Bhartiya is arguably the most trusted glaucoma specialist in Gurgaon, maintaining a perfect 5.0-star rating across 1,500+ verified patient reviews. She is widely sought after for ethical glaucoma care and second opinions, specializing in:

  • Evidence-Based, Non-Surgical Protocols
  • Complex Glaucoma Management (Medical & Surgical)
  • Neuro-Ophthalmology & Ocular Surface Diseases
  • Minimally Invasive Glaucoma Surgery (MIGS)

Focus Areas: Providing advanced diagnosis, glaucoma treatment, risk stratification, and second opinions for glaucoma and optic nerve disease. Long-term vision protection.

The Ethical Care Philosophy

Dr. Bhartiya is known for her “patient-first” approach, focusing on long-term vision preservation rather than unnecessary surgical intervention. Her practice is built on transparency, humane care, and the same rigorous standards found at the world’s leading eye institutes.

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist  in Gurgaon, currently serving as Clinical Director of Ophthalmology at Marengo Asia Hospitals, Sector 56, Gurugram, and as Research Collaborator at Mayo Clinic, Jacksonville, Florida, USA.

Her clinical focus is glaucoma across its full spectrum- from early detection and borderline disease to complex surgery and second opinions for patients who need clarity on a difficult diagnosis. She also sees patients with neuro-ophthalmological conditions and ocular surface disease.

Dr Bhartiya trained at AIIMS New Delhi, completed a Clinical Research Fellowship in Glaucoma at the University of Geneva, Switzerland, and is currently enrolled for a Doctorate en Médecin at the University of Geneva. Over two decades of glaucoma specialty practice, international research collaboration, and editorial leadership in glaucoma have shaped an approach to care that is careful, long-term, and built around protecting vision, and not just treating numbers.

What I Treat

My practice is focused on patients with glaucoma at every stage — from those who have just been told they may be a glaucoma suspect, to those managing advanced disease after failed surgery. I also see a significant number of patients who come for a structured second opinion, from Gurgaon, NCT and all over India, often after an unclear diagnosis or conflicting advice from different doctors.

Conditions I see regularly: — Primary open-angle glaucoma and normal tension glaucoma — Angle closure glaucoma and angle closure suspects — Ocular hypertension and glaucoma suspects — Secondary glaucomas: steroid-induced, post-uveitic, post-traumatic, after retinal surgery or corneal transplant  Neovascular and complex refractory glaucoma

 Neuro-ophthalmological conditions: optic neuropathy, unexplained visual field loss, optic neuritis, papilledema — Ocular surface disease and dry eye in the context of glaucoma treatment

If you are unsure whether your situation fits, the contact page has details for reaching my coordinator directly. You can also reach me through the Marengo Asia Hospitals appointment page here

Training and Qualifications

Fellowship Training

Clinical Research Fellowship in Glaucoma, Clinique d’Ophtalmologie, Department of Clinical Neurosciences, Hôpitaux Universitaires de Genève, University of Geneva, Switzerland (2010–11).

Also enrolled: Doctorat en Médecin, University of Geneva.

Senior Clinical Research Associate, Cornea and Glaucoma Services, Dr R P Centre for Ophthalmic Sciences, AIIMS, New Delhi (2007–10).

MS Ophthalmology, Maulana Azad Medical College, New Delhi (2007–10).

Current Positions

Clinical Director, Ophthalmology, Marengo Asia Hospitals, Gurugram (July 2024 to date) Program

Director, Community Outreach & Wellness,  Marengo Asia Hospitals, Gurugram and Faridabad

Program Director, Marengo Asia International Institute of Neuro & Spine (Pan-India)

Research Collaborator, Mayo Clinic, Jacksonville, Florida, USA (September 2024 to date)

Academic and Editorial Leadership

Dr Bhartiya holds editorial positions at three international peer-reviewed journals:

 Editor-in-Chief, Clinical and Experimental Vision and Eye Research 

Editor-in-Chief, Ocular Research Journal

Executive Editor, Journal of Current Glaucoma Practice

She is a Member of the Associate Advisory Committee, International Society of Glaucoma Surgery, and serves on the Delhi Ophthalmic Society International Advisory Sub-Committee.

She has edited more than 20 textbooks in glaucoma and ophthalmology, and contributed chapters to more than 20 others. Her peer-reviewed research is indexed on PubMed and Google Scholar.

Awards and Recognition

Best Paper, Glaucoma Session — APAO, Hyderabad (Continuous IOP Monitoring in Glaucoma)

Best Paper, Glaucoma Session and Top Nine Most Influential Papers — Asia Pacific Glaucoma Congress, Bali 2012 (Diurnal IOP Fluctuation in Angle Closure)

 Multiple best paper recognitions at International Society for Glaucoma Surgery congresses

Global Outreach and Community Work

Beyond clinical practice, Dr Bhartiya has led glaucoma screening and surgical programmes in underserved communities across three continents.

In Egypt, she led a humanitarian mission to Kom Ombo General Hospital, Aswan, conducting screening for over 5,000 patients including children, and provided both medical and surgical management of advanced glaucomas in North Africa. She has also delivered skill-transfer sessions in advanced glaucoma care for doctors, residents, and optometrists in Aswan.

In Switzerland, she designed and executed hospital-based and community glaucoma screening protocols in Geneva and Troinnex, and led screening of United Nations personnel as part of World Glaucoma Week.

In India, she is an active contributor to the Motiabind Mukti Abhiyan cataract outreach programme, has led eye camps in Sirsa (Haryana), and runs school health initiatives and government employee screening programmes in Gurugram.

She is also the founder of Vision Unlimited, a not-for-profit organisation currently running six learning centres in urban Gurugram, serving over 1,200 children with education, nutrition, and healthcare support.

As part of the Eye on the Future program, Vision Unlimited under the guidance of Dr Bhartiya has screened more than 15000 school children; and 5000 elders from underserved areas for refractive errors, and other ocular morbidities. 

Research

Active clinical research collaborations span glaucoma medication adherence, quality of life, IOP monitoring, community-based screening, and surgical outcomes. Dr Bhartiya collaborates with glaucoma specialists across more than 20 countries.

Current trials include work on 24-hour ambulatory IOP monitoring, selective laser trabeculoplasty as primary therapy, tear film osmolarity in glaucoma patients, and quantitative versus qualitative IOP control, as well as metabolic determinants of glaucoma.

Full publication list: PubMed · Google Scholar · Publications page

Book an Appointment

For appointments at Marengo Asia Hospitals, Sector 56, Gurugram, please contact my coordinator at +91 88826 38735.

If you are seeking a structured glaucoma second opinion, you may also use the second opinion form to submit your reports in advance of your consultation.

As a fellowship-trained glaucoma specialist (from University of Geneva, Switzerland, and AIIMS, New Delhi) in Gurgaon, Dr Shibal Bhartiya works with patients across the full spectrum of glaucoma—from suspects and early disease to advanced and complex cases. Her approach emphasises risk stratification, longitudinal follow-up, and calm decision-making, helping patients avoid late surprises and unnecessary interventions.

Patients often seek her care for early glaucoma diagnosis, second opinions, treatment planning, and long-term glaucoma management (medical, glaucoma lasers and glaucoma surgery including MIGS, trabeculectomy and complex tubes and shunts), especially when clarity is needed in uncertain, complex, or borderline cases.

Academic Qualifications:

  • 2010-11 – Clinical Research Fellowship, Glaucoma, University of Geneva, Switzerland
  • 2007-10 – MS (Ophthalmology), Maulana Azad Medical College, New Delhi, India
    1993-99 – M.B.B.S, Maulana Azad Medical College, New Delhi
  • 2000-03 – Clinical Research Associateship, Cornea and Glaucoma, Dr R P Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
  • Doctorate en Medicin, University of Geneva, Switzerland (Currently enrolled)

Experience details:

  • July 2024 to date- Clinical Director, Ophthalmology (MAH, Gurgaon); Program Director, Community Outreach & Wellness (MAH, Gurgaon and Faridabad)
    Program Director, Marengo Asia International Institute of Neuro & Spine (Pan-India)
  • Sept 2024 to date– Research collaborator, Mayo Clinic, Jacksonville, USA
  • 2019 to Date: Member, Associate Advisory Board, International Society of Glaucoma Surgery
  • 2012-July 2024- Director, Additional Director, Sr. Consultant, Consultant – Ophthalmology, Fortis Memorial Research Institute, India

Additional Role

  • Sept 2024 – till date- Research collaborator, Mayo Clinic, Jacksonville, USA
  • August 2015-October 2015- Consultant, Cantahealth, Healthcare Practice, Eliglobal, Charlotte, North Carolina, USA. (Training and development of AI platforms and interfaces in Ophthalmology)
  • Oct 2015- April 2017- Clinical Director, Medflow, Eye Care Leaders (Eliglobal), Charlotte, North Carolina, USA. (Training and development of AI platforms and CDSS interfaces in Ophthalmology)
  • Sept 2012 to Aug 2015 – Consultant, Glaucoma and Preventive Health Services, Department of Ophthalmology, Fortis Memorial Research Institute, Gurgaon, Haryana
  • Sept 2011 to Aug 2012 – Consultant Glaucoma and In charge of Academics and Research, Eye 7 Group of Hospitals, New Delhi
  • Jul 2010 to Jul 2011 – Senior Scientific- Clinical Research Fellow, Glaucoma Sector, Clinique d’ ophthalmologie, Department of Clinical Neurosciences, Glaucoma Sector, Hopitaux Universitaires de Geneve, Switzerland. (Responsibilities including teaching resident doctors and glaucoma fellows)
  • Mar 2007 to Mar 2010 – Senior Research Associate, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, AIIMS, New Delhi. (Responsibilities including teaching resident doctors)
  • Sept 2003 to Sept 2006 – Senior Registrar, University College of Medical Sciences, and associated Guru Teg Bahadur Hospital, New Delhi. (Responsibilities including teaching resident doctors)

Languages known:

English, Hindi, Urdu, French

Academic, Organisational and Leadership positions:

  • 2024 – Present- Editor in Chief, Ocular Research Journal
  • 2017-to date: Founder, Vision Unlimited, Not for Profit Organization for social responsibility https://vision-unlimited.org/
  • 2019-to date – Editor in Chief –Clinical and Experimental Vision and Eye Research https://www.cleverjournal.org/ https://www.cleverjournal.org/editorial-team/
  • 2016-to date –  Executive Editor – Journal of Current Glaucoma Practice https://www.jocgp.com/journalDetails/JOCGP https://www.jocgp.com/editorialBoard/JOCGP
  • 2019 to Date: Member, Associate Advisory Board, International Society of Glaucoma Surgery
  • 2024 to Date- Member, Program Committee, Bal Raksha Bharat, Save the Children, India
  • 2016 to 2021: Executive Editor-DOS Times
  • 2016-till date: Founder Member, Khem, LGBTQ Rights
  • 2009 to 2016 – Managing Editor – Journal of Current Glaucoma Practice
  • 2023 to date- Member, Delhi Ophthalmic Society International advisory sub-committee
  • 2011 – Founding Secretary – Shamms Ed Deen Alcon Glaucoma Fund, University of Geneva, Switzerland
  • 2013 – Member Scientific Committee – World Glaucoma Congress
  • 2012 – Member Scientific Committee – International Society for Glaucoma Surgery
  • 2010 – Member, Organising Committee – International Society for Glaucoma Surgery
  • Apr 2008 to Dec 2009 – Associate Editor – Delhi Journal of Ophthalmology
  • 2008 – Co-Editor – Proceedings of the Strabismic Panorama
  • 2001 to 2003 – Assistant Editor – Indian Journal of Strabismology and Pediatric Ophthalmology
  • 2007 to 2008 – Deputy Editor – Delhi Journal of Ophthalmology
  • Reviewer for several journals worldwide.

Professional Memberships:

  • International Society of Glaucoma Surgery
  • Glaucoma Society of India
  • Strabismological Society of India
  • All India Ophthalmological Society
  • Delhi Ophthalmological Society
  • Haryana Ophthalmological Society
  • Gurugram Ophthalmological Society
  • American Academy of Ophthalmology
  • Association for Research and Vision in Ophthalmology

Community Ophthalmology Programmes:

  • Responsible for design of skill transfer sessions in glaucoma care, and for screening manuals for glaucoma in Africa and the Middle East. Projected collaboration in execution
  • Skill transfer sessions in advanced glaucoma care in Aswan, Egypt for doctors, residents and optometrists
  • Humanitarian mission to Kom Ombo General Hospital, Aswan, Egypt. Screening program for over 5000 patients, including children for glaucoma in Kom Ombo General Hospital, Aswan, Egypt
  • Management, both medical and surgical, of advanced glaucomas in North Africa
  • Screening for glaucoma and designing and execution of protocols and SOPs for hospital based and community outreach programs, Geneva and Troinnex, Switzerland
  • Screening of UN personnel for glaucoma in an outreach exercise as part of World Glaucoma Week in Geneva, Switzerland
  • Actively involved in the Motiabind Mukti Abhiyan, an outreach program for cataract management in India
  • Execution of eye camps in Sirsa, Haryana, as part of a community sponsored initiative
  • School health and eye care initiatives, Gurugram, Haryana
  • Screening programs for police officers and government officials in Gurugram, Haryana
  • Screening programs for community based screening in Pilibhit, UP and Mewat, Haryana

Design of clinical trials:

  • Population based survey of anterior chamber configuration in North African populations
  • Histochemical correlates of chronic glaucoma medication use on trabecular meshwork and ocular surface
  • Persistency, adherence and compliance to glaucoma medications
  • Selective laser trabeculoplasty as primary therapy in an African population: An efficacy and economics perspective
  • Tear film osmolarity studies in patients on glaucoma therapy
  • Comparative evaluation of sclerothalamotomy ab interno combined with phacoemulsification versus phacoemulsification alone in POAG patients
  • Quantitative versus qualitative control of IOP: A risk benefit analysis
  • 24 hour ambulatory IOP monitoring in angle closure glaucoma
  • Effect of increased intraocular pressure on retinal ganglion cells in chick embryos

Awards

  • Continuous IOP Monitoring In Glaucoma Patients Treated With Tafluprost. Shibal Bhartiya, Aref A, Shaarawy T. APAO, Hyderabad, India. Best Paper, Glaucoma session
  • Diurnal Intraocular Pressure Fluctuation in Eyes with Angle Closure. Shibal Bhartiya, Ichhpujani P. Asia Pacific Glaucoma Congress 2012, Bali, Indonesia. Best paper glaucoma session, Top nine most influential papers of the congress
  • Harry Potter and the Ophthalmologists Nemesis: Shibal B., S Khokhar, IV International Congress of Glaucoma Surgery, April 2009, Geneva. Best Poster
  • Comparative evaluation of time domain and spectral domain optical coherence tomography in retinal nerve fiber layer thickness measurements. S.Bhartiya, Jayaprakash V, T Dada, A Panda. DOS Annual Conference, March 2009.Best free paper, glaucoma session.
  • Evaluation of levo-dopa as a therapeutic adjunct to conventional occlusion in amblyopia; Kamlesh, Dadeya S, Shibal F. DOS Midcon, 2001 .Best free paper, squint session.
  • Asia ARVO Young Scientists Travel Grant for the year 2008
  • CSIR Young Scientists Travel Grant for the year 2003,2009
  • World Glaucoma Association Young Scientists Travel Grant for the year 2009, 2013Ju

CV

Complete list of publications

Published Articles

view all

Quality of Life concerns

Glaucoma is often called the silent thief of sight. Most patients feel no pain. Vision loss creeps in slowly, from the edges. By the time you notice something is wrong, significant damage may already have occurred.

But glaucoma is about more than vision loss. It affects how you live, work, drive, read, and feel. This page explains how glaucoma impacts quality of life — and what you can do about it.

 

Key fact: Glaucoma is the leading cause of irreversible blindness worldwide. In India, over 12 million people are affected — and many do not know it.

 

What Is Quality of Life in Glaucoma?

Quality of life (QoL) means how well you function in daily life. It includes physical ability, emotional wellbeing, independence, and social participation.

In glaucoma, QoL can be affected even when vision seems good on standard tests. Patients may struggle with:

  • Reading fine print or screens
  • Driving, especially at night
  • Walking safely in dim light
  • Recognising faces in crowds
  • Feeling anxious about future vision loss

 

Research shows that glaucoma patients score lower on QoL measures than people with other chronic conditions — including arthritis, diabetes, and heart disease. The impact is real, even in early disease.

 

How Glaucoma Affects Daily Life

1. Reading and Near Vision Tasks

Glaucoma damages the optic nerve. This creates blind spots — areas where you cannot see. In early glaucoma, these spots appear at the edges of your vision. As disease progresses, they move closer to the centre.

Reading requires sharp central vision and smooth eye movement. Even mild peripheral loss can make reading slower and more tiring. Patients often describe losing their place on the page or struggling with small text.

 

2. Driving

Driving is a major concern for glaucoma patients. You need wide peripheral vision to drive safely. Glaucoma narrows this field gradually.

Studies show glaucoma patients have a higher risk of motor vehicle accidents. Night driving is especially difficult. Glare from headlights and poor contrast sensitivity make it harder to see the road clearly.

In India, many patients depend on driving for work and family. Losing this ability affects income, independence, and confidence.

 

3. Falls and Physical Safety

Peripheral vision helps you detect obstacles. When it narrows, your risk of tripping and falling increases. Studies show glaucoma patients fall more often than people with normal vision.

Falls can cause fractures, head injuries, and loss of confidence. Older patients may reduce outdoor activity to avoid falling — which leads to isolation and poor physical health.

 

4. Emotional Wellbeing and Mental Health

Living with a progressive, irreversible eye disease is stressful. Patients commonly experience:

  • Anxiety about further vision loss
  • Depression, especially in advanced disease
  • Fear of becoming dependent on others
  • Frustration with daily eye drop routines

 

Research from leading ophthalmology journals confirms that depression and anxiety are significantly more common in glaucoma patients. These are not minor concerns. They are part of the disease burden and deserve attention.

 

If you feel anxious or low about your glaucoma diagnosis, you are not alone. Talk to your eye doctor. Emotional support is part of good glaucoma care.

 

5. Work and Productivity

Glaucoma can affect your ability to work, particularly in jobs that require sharp vision, fine motor skills, or driving. Patients may need to reduce working hours, change roles, or stop working in advanced disease.

This has financial consequences — and affects self-esteem and sense of purpose.

 

6. Social Life and Independence

Many glaucoma patients withdraw from social activities. They avoid crowded places, unfamiliar environments, or activities in low light. Over time, this leads to loneliness and reduced independence.

Family members feel the impact too. Caregivers often adjust their own lives to support a loved one with glaucoma.

 

Does Treatment Improve Quality of Life?

Yes — when started early. The goal of glaucoma treatment is to slow or stop damage to the optic nerve. Protecting your remaining vision protects your QoL.

However, treatment itself can affect QoL. Eye drops must be used every day. Some cause redness, stinging, or blurred vision. The routine can feel burdensome.

Modern treatments aim to reduce this burden:

 

Treatment

Quality of Life Benefit

Daily eye drops

Controls pressure; most widely used first-line treatment

Laser (SLT)

Reduces or eliminates drop dependency in many patients

MIGS

Lowers pressure with faster recovery and fewer drops needed

Trabeculectomy / tube surgery

Effective long-term pressure control in advanced disease

 

For many patients, laser or surgery reduces the number of drops needed. Fewer drops often means better adherence — and better quality of life.

 

The Importance of Early Detection

Most QoL loss in glaucoma is preventable. The key is finding the disease early, before significant vision loss occurs.

Glaucoma has no symptoms in its early stages. The only way to detect it is through a comprehensive eye examination. This includes:

  • Measuring eye pressure (tonometry)
  • Examining the optic nerve (slit lamp and dilated exam)
  • Testing your visual field (perimetry)
  • Imaging the optic nerve and retinal nerve fibre layer (OCT)

 

At-risk groups who should be screened regularly include:

  • People over 40 years of age
  • Those with a family history of glaucoma
  • People with diabetes, high blood pressure, or severe myopia
  • Anyone who has used steroid eye drops or tablets for a long time

 

Early glaucoma detected before vision loss begins allows treatment that can protect your sight — and your quality of life — for decades.

 

What You Can Do to Protect Your Quality of Life

Use Your Drops Every Day

The single most important thing you can do is use your prescribed eye drops consistently. Missing doses allows eye pressure to rise and the optic nerve to sustain more damage.

Set a daily alarm. Keep drops at eye level. Pair the routine with something you already do — like brushing your teeth.

 

Attend All Follow-Up Appointments

Glaucoma needs regular monitoring. Visual field tests and OCT scans track whether the disease is stable or progressing. Do not skip appointments even if your vision feels unchanged.

 

Tell Your Doctor About Side Effects

If drops cause irritation, redness, or blurring, tell your doctor. There are many alternatives. Do not stop drops without advice — but do not suffer in silence.

 

Protect Your Vision at Home

Good lighting reduces visual strain. Use bright, directed light for reading. Remove trip hazards at home. Use handrails on stairs. These small adjustments reduce fall risk significantly.

 

Seek Emotional Support

A glaucoma diagnosis can feel overwhelming. Talk to your doctor about your concerns. Support groups, counselling, and family involvement all help. You do not have to manage this alone.

 

Get a Second Opinion if Uncertain

If you have been told you have glaucoma, or are at risk, and feel unsure — seek a specialist opinion. A fellowship-trained glaucoma specialist can review your investigations, clarify the diagnosis, and recommend the most appropriate treatment for your situation.

 

Frequently Asked Questions

Can glaucoma patients live a normal life?

Yes. With early detection and consistent treatment, most glaucoma patients maintain good functional vision and lead independent, active lives. The key is not to delay diagnosis or treatment.

 

Will I go blind from glaucoma?

Most people with glaucoma do not go blind if the disease is detected and treated early. Blindness from glaucoma is largely preventable. However, advanced or untreated glaucoma can cause severe, irreversible vision loss.

 

Can I still drive with glaucoma?

Many glaucoma patients continue to drive safely, particularly in early disease. Your doctor will assess your visual fields to determine whether driving is safe. Follow their guidance and inform your licensing authority if required.

 

Does stress worsen glaucoma?

Emotional stress does not directly raise eye pressure in most people. However, stress can affect medication adherence and overall wellbeing. Managing stress is an important part of living well with glaucoma.

 

How do I know if my glaucoma is getting worse?

Glaucoma often worsens without noticeable symptoms. That is why regular monitoring — visual field tests and OCT — is essential. Your doctor will compare results over time to detect any change.

 

A Note from Dr. Shibal Bhartiya

In my clinical practice in Gurgaon, I see patients every day who are anxious, confused, or have been living with untreated glaucoma for years. My goal is not only to protect their optic nerve — it is to help them live confidently with this diagnosis.

Quality of life matters as much as eye pressure numbers. I take time to understand each patient’s work, lifestyle, and concerns before recommending treatment. The right plan is the one that fits your life — and that you can actually follow.

If you have been diagnosed with glaucoma, or have concerns about your vision or eye pressure, I welcome you for a consultation. Whether you need a first assessment or a second opinion, I am here to help.

Some Questions Patients Ask

  1. I have glaucoma. I am pregnant. What do I do?

Ideally, you should have discussed with your ophthalmologist that you were planning to have a baby. The doctor could have suggested alternate methods for lowering your eye pressures, since most eye drops can have a deleterious effect on your baby. The most common alternative is Selective Laser Trabeculoplasty, SLT.

Now, your doctor will carefully consider the potential dangers to the baby with the risk of worsening glaucoma in your eyes. These precautions hold true for your pregnancy, as well as during the time that you are breastfeeding, since the glaucoma medicines are found in both your bloodstream and breast milk.

In case eye drops are essential, you can minimize the absorption of the medication into your bloodstream, and that of the baby, by gently pressing on the inside corner of the eye (nasolacrimal occlusion).

See technique for putting eye drops.

  1. How will glaucoma medications affect my baby?

Any glaucoma medication may affect the baby, especially during the first three months of pregnancy. Please understand that all of the information we possess is from laboratory studies, conducted on animals, and may not be exactly true for human beings. That said, it is extremely important to stay vigilant about your glaucoma drops during both pregnancy, and lactation.

Carbonic anhydrase inhibitors should be used with caution in the first trimester because of reports of deformity of the embryo. Beta blockers get concentrated in breast milk, and should be avoided if possible by nursing mothers. Pilocarpine has shown no effects when used in early pregnancy, but can cause fits in the newborn. Prostaglandins may induce premature labour

  1. I have glaucoma. Can I go ahead with LASIK for spectacle removal?

Glaucoma is a not an absolute contraindication for LASIK. However, LASIK permanently alters the shape and properties of your cornea, making subsequent eye pressure recordings unreliable.

Also, the high pressure exerted on the eye during LASIK may injure the already compromised optic nerve. Steroid eye drops that are used post operatively may also result in pressure spikes in predisposed eyes.

Most doctors, therefore, prefer to rule out glaucoma before LASIK is planned, and deter patients with diagnosed from the procedure. A safer procedure would be femtosecond laser or photorefrative keratotomy, PRK, in case the patient’s visual needs are significant.

  1. I have had LASIK. Now my doctor says I have glaucoma. How is it possible?

Diagnosing and monitoring glaucoma in patients after LASIK is challenging for your eye doctor. Very often, since the cornea is thin after LASIK, the available devices underestimate eye pressures. The doctors rely heavily on optic nerve examination and visual fields to diagnose glaucoma.

In susceptible eyes, the brief but significant rise in eye pressures during LASIK can cause optic nerve damage. The use of steroids in the postoperative period can cause a steroid induced glaucoma. It is also possible that a diagnosis of glaucoma was missed before surgery, or you developed the disease recently.

  1. I have glaucoma. Can I drive?

Most glaucoma patients can go about their life without any functional impairment. However, in severe disease your doctor may ask you to restrict your driving, or stop it all together because of advanced field loss.

  1. I have glaucoma. Can I exercise?

Yes. Exercise is known to help maintain your general fitness and also is known to be an important stress buster. Yoga is known to help manage both physical fitness and stress as well. There is some evidence that the headstand or the shirshaasan may result in brief but significant rise in eye pressures, and so must be avoided in glaucoma patients.

  1. I have glaucoma? I also have cataract!

Both cataract and glaucoma are more common in the older age group, they often co-exist. Sometimes treatment for one can contribute to the development of the other.

Glaucoma typically has no symptoms, but the loss of vision due to it is irreversible. On the other hand, cataract results in clouding of vision which can be reversed by surgery.

Your doctor will therefore evaluate the severity of each before deciding on the treatment plan. Typically, most doctors would want your eye pressures to be controlled before cataract surgery. The usual exception to this rule is when your visual needs are such that waiting for eye pressure control is difficult. The second situation is in case of angle closure glaucoma, where your doctor might want to remove the cataract earlier to obviate the need for a laser peripheral iridotomy.

Read the research articles

This article has been written by Dr Shibal Bhartiya, a glaucoma specialist in Gurgaon known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also a research collaborator with Mayo Clinic, Jacksonville, Florida, USA.

She has published peer-reviewed research on glaucoma laser and surgeries, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

These peer-reviewed article discussing glaucoma treatment are benchmarks for glaucoma surgeons globally, and can be accessed on PubMed and Google Scholar 

Consultation Information

Dr Shibal Bhartiya
Glaucoma Specialist | Neuro-Ophthalmology | Second Opinions

www.drshibalbhartiya.com
+91 88826 38735

 

In case you are planning cataract surgery, please remember that multifocal IOLs (intraocular lenses) are to be used with caution in patients with moderate to severe glaucoma.

 

Glaucoma Treatment in Gurgaon

Glaucoma Treatment in Gurgaon: Eye drops, Laser and Surgery Explained by Dr Shibal Bhartiya, a fellowship trained glaucoma specialist.

Glaucoma treatment is not one-size-fits-all. The right treatment depends on your glaucoma type, your optic nerve health, your age, your lifestyle, and how fast your disease is progressing. The goal is never just to lower a number, it is to protect the optic nerve over the long arc of your life. This page explains all three treatment options: eye drops, laser, and surgery.

Glaucoma is a chronic disease. It cannot be cured, but it can be controlled. With the right glaucoma treatment, most patients keep their vision for life. This page explains the three main glaucoma treatment options: eye drops, laser procedures, and surgery.

It answers the questions patients most commonly ask about each. If you have been recently diagnosed, or if you are reviewing your current treatment plan, this guide will help you understand your options and what to expect.

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist in Gurgaon with expertise in all three treatment modalities, including minimally invasive glaucoma surgery (MIGS). If you have questions about your specific situation, a structured consultation or second opinion can bring clarity.

Q1. I have glaucoma. What are my treatment options?

Your doctor will first perform a test called gonioscopy to determine your glaucoma subtype: open angle or closed angle. This guides all treatment decisions.

For open-angle glaucoma, treatment usually starts with eye drops to lower eye pressure. Your doctor will monitor their effect over time and adjust as needed. A laser procedure called selective laser trabeculoplasty (SLT) may also be offered, either as a first-line treatment or alongside drops.

For closed-angle glaucoma, a laser procedure called laser peripheral iridotomy (LPI) is the first step. It creates an alternative drainage channel in the iris. Eye drops may be added after.

If drops and laser do not achieve adequate pressure control, particularly in advanced glaucoma or complex subtypes, surgery is recommended. Options include trabeculectomy, minimally invasive glaucoma surgery (MIGS), and tube shunt implants such as the Ahmed Glaucoma Valve.

— Eye Drops —

Q2. What are the common glaucoma medications?

The table below lists the most commonly used glaucoma eye drops. This is not an exhaustive list. Your doctor will prescribe what is most appropriate for your eye pressure, general health, and lifestyle, and customise your glaucoma treatment to best preserve your vision long term.

Class

Drug Name

Action

Half-life

Dosage

Brand Names (India)

Prostaglandin Analogues

Latanoprost

Outflow

Long

Once at bedtime

Xalatan, Latoprost RT
 

Travoprost

Outflow

Long

Once at bedtime

Travatan
 

Bimatoprost

Outflow

Long

Once at bedtime

Lumigan

Beta Blockers

Timolol

Inflow

Moderate

Twice daily

Iotim, Glucomol, Timolol GFS
 

Levobunolol

Inflow

Moderate

Twice daily

Betagan
 

Betaxolol

Inflow

Moderate

Twice daily

Betoptic

Alpha Agonists

Brimonidine

Inflow / Outflow

Moderate

Three times daily

Alphagan

Carbonic Anhydrase Inhibitors

Acetazolamide (tablet)

Inflow

Short

Three times daily / SOS

Diamox, Iopar SR
 

Dorzolamide

Inflow

Shorter

Three times daily

Dorzox
 

Brinzolamide

Inflow

Shorter

Twice daily

Azopt

Miotics

Pilocarpine

Outflow

Short

Three times daily

Pilocarpine

Q3. My eye pressure is normal after medication. Do I still need to take my drops?

Yes, always. Your eye pressure is normal because the drops are working. If you stop, the pressure will rise again within days.

Think of glaucoma like high blood pressure or diabetes. Medication controls the condition; it does not cure it. Stopping glaucoma treatment puts your vision at risk.

Important to Understand: What is my target eye pressure?

Target IOP is the pressure level that will keep your specific optic nerve stable over your lifetime. It is not the same for every patient. Someone with early glaucoma and a healthy nerve may have a target of 18 mmHg. Someone with advanced damage may need a target below 12. Your target is set based on your optic nerve, your rate of progression, your age, and your individual risk. It changes over time as new information comes in

Q4. Can I switch to a generic medicine?

Generic eye drops contain the same active ingredient at the same concentration, and are chemically equivalent to branded products. In most cases, they are appropriate to use.

However, equivalence in eye drops is harder to guarantee than with tablets, because blood levels cannot be monitored. Small differences in preservatives, drop size, or packaging can affect how well the drop is absorbed and how comfortable it feels.

Discuss any switch with your doctor. If your eye pressures remain stable and the drop is comfortable, a generic may be a reasonable, cost-effective option for glaucoma treatment.

Q5. What are the side effects of glaucoma eye drops?

Almost all glaucoma drops can cause some eye dryness or local irritation. Allergic reactions are possible with any medication. Specific side effects by drug class include:

  • Prostaglandin Analogues: Darkening of iris or eyelid skin (especially with light eyes), redness, stinging, blurred vision, growth of eyelashes.
  • Beta Blockers: Slowed pulse, fatigue, shortness of breath (particularly in asthma patients), reduced libido, low mood.
  • Alpha Agonists: Stinging, fatigue, headache, drowsiness, dry mouth and nose.
  • Carbonic Anhydrase Inhibitors (eye drop): Stinging, altered taste.
  • Carbonic Anhydrase Inhibitors (oral tablet): Tingling in hands and feet, stomach upset, confusion, low mood, metabolic imbalances.

Note: Preservative Free Glaucoma Eye drops

Most standard glaucoma drops contain a preservative called BAK (benzalkonium chloride). BAK keeps the bottle sterile, but it also irritates the surface of the eye. Used daily for years, it can cause chronic dry eye, redness, and a condition called ocular surface disease.

This matters more than most patients realise. If your eyes are constantly irritated, you are less likely to use your drops consistently. And inconsistent drops mean uncontrolled pressure.

Preservative-free formulations of most common glaucoma medications now exist, including prostaglandins, beta blockers, and fixed combinations. They cost more, but for patients on long-term treatment, or those already prone to dry eye, they are often the right choice.

If your eyes feel persistently dry, red, or irritated on your current drops, tell your doctor. It may not be the medication itself, it may be the preservative. Switching formulation is a simple change that can make a significant difference to both comfort and adherence.

📌 Always tell your doctor if you experience new symptoms. Many side effects can be managed by switching to a different class of drop. A second opinion may help if you are struggling.

If you would like a structured glaucoma risk assessment or second opinion about ocular discomfort and side effects of glaucoma eye drops, you can contact my coordinator for a time slot at+91 88826 38735

Q6. How do I put in my eye drops correctly?

Follow your doctor’s instructions on dose and timing. These steps help ensure the drop reaches the eye and stays in:

  • Wash your hands before you begin.
  • Tilt your head back while seated, or lie down.
  • Gently pull your lower lid down with one finger to form a small pocket.
  • Look up and squeeze one drop into the pocket. Avoid touching the dropper tip to your eye or hand.
  • Close your eyes for two minutes. Press gently on the inner corner of the closed eye with your fingertip, this reduces absorption into the bloodstream.
  • If you use more than one type of drop, wait five minutes between each.
  • Blot any excess from around the eye with a clean tissue.

📌 If your hands shake, rest your hand against your face and approach from the side. If arthritis makes squeezing difficult, ask your doctor about a bottle-squeezing assistive device.

Q7. I keep forgetting to take my eye drops. What can I do?

You are not alone. Adherence is one of the biggest challenges in glaucoma treatment. Missed drops mean higher pressure and faster disease progression.

Practical strategies that help:

  • Set a recurring alarm on your phone and act on it immediately.
  • Keep your drops on your bedside table and link them to a fixed habit, such as removing your glasses at bedtime. (Note: Xalatan requires refrigeration until opened, after which it can be stored at room temperature.)
  • Download an eye drop reminder app, search ‘eye drop reminder’ on the App Store or Google Play.
  • Ask a family member to remind you, or help you track your drops.
  • Use the same system for scheduling your doctor appointments, a shared calendar or phone reminder works well.

— Laser Treatment —

Q8. I have been advised laser iridotomy. What is that?

A laser peripheral iridotomy (LPI) is used to treat or prevent closed-angle glaucoma. The laser creates a tiny opening in the iris, allowing fluid to flow more freely within the eye and preventing dangerous pressure spikes.

Before the procedure, your doctor will instil drops to make your pupil smaller. A local anaesthetic drop is then applied so you feel no pain. A small lens is placed on your eye to improve visibility, and you are asked to look at a red light while the laser is applied.

Most patients experience mild discomfort, but the procedure is brief. Vision may be blurred for up to three days after. Your doctor will usually prescribe steroid drops for about a week.

Q9. I have been advised selective laser trabeculoplasty (SLT). What is that?

SLT is used for open-angle glaucoma. A low-energy laser is applied to the drainage angle of the eye. This stimulates the body’s own immune response to improve fluid outflow and lower eye pressure.

Before the procedure, drops are instilled to constrict the pupil and an eye pressure-lowering agent is given about an hour beforehand. A local anaesthetic drop is applied just before the procedure. You will sit at the laser machine with your face in a chin rest, and a contact lens is placed on the eye, as in a gonioscopy. You may feel a brief twinge or sting as the laser is applied.

Afterwards, you will use anti-inflammatory drops for up to a week. Continue all glaucoma medications as before unless told otherwise. Eye pressure is checked an hour after the procedure and again at one week.

📌 SLT takes one to three months to reach peak effect and may be temporary. Continued follow-up is essential. SLT can often be repeated if the effect wears off.

— Surgery —

Q10. What is trabeculectomy? Why might I need it?

Trabeculectomy is the most established glaucoma surgery. It is recommended when eye drops and laser have not adequately controlled your eye pressure, or when glaucoma is advanced at the time of diagnosis.

The surgeon creates a small flap in the white of the eye (sclera) through which fluid can drain out, collecting under the conjunctiva as a small elevation called a bleb. You may be able to see the bleb under your upper eyelid if you look in a mirror.

Trabeculectomy is highly effective in reducing eye pressure, and is the gold standard for surgical glaucoma treatment. It does carry risks, which your doctor will discuss with you before the procedure.

Q11. What is minimally invasive glaucoma surgery (MIGS)?

MIGS is a newer category of glaucoma surgery designed to lower eye pressure with less disruption to the eye than traditional surgery. It is often performed at the same time as cataract surgery.

MIGS procedures include devices such as iStent, Hydrus Microstent, and PRESERFLO MicroShunt. They work by improving drainage through the eye’s natural channels, or by creating a new drainage pathway with less tissue disruption.

MIGS is typically suitable for mild to moderate glaucoma where drops are insufficient or poorly tolerated. It carries a lower risk of complications than trabeculectomy but may produce a more modest pressure reduction.

Dr Shibal Bhartiya offers MIGS as part of a comprehensive glaucoma treatment strategy. If you would like to know whether MIGS is suitable for you, a second opinion consultation can help clarify your options.

Q12. What is an Ahmed Glaucoma Valve?

An Ahmed Glaucoma Valve (AGV) is a small silicone drainage implant placed in the eye to allow fluid to drain to a reservoir under the conjunctiva. It is a type of tube shunt surgery.

Your doctor may also place a small piece of donor sclera (white of the eye) to cover the tube and prevent it from working its way out.

Q13. Why am I getting an Ahmed Valve rather than a trabeculectomy?

Both procedures are proven to be equally effective and safe in the long term. Your doctor will recommend the best option based on your individual history.

An Ahmed Valve is often preferred in the following situations:

  • Previous failed trabeculectomy: a repeat trabeculectomy has a lower chance of success.
  • Certain complex glaucoma subtypes, including inflammatory, neovascular, and post-vitreoretinal surgery glaucomas, or cases with scarred corneas.
  • Your doctor may reserve the Valve as a second-line procedure because of its higher cost.

Q14. What will I feel during surgery?

Most glaucoma surgeries are performed under local anaesthesia. You will receive an injection around the eye to numb it completely, and an intravenous medication to lower eye pressure before the procedure begins.

You will lie on your back. The area around your eye is cleaned, and a sterile drape is placed over your face. If you feel claustrophobic or are asthmatic, tell your anaesthetist in advance, oxygen can be delivered under the drape.

A small clip keeps the eyelid open so you do not need to worry about blinking. You will see the bright light of the surgical microscope. Your vision will blur as the surgery progresses.

You may feel some pressure or tugging, but surgery is largely painless. Most patients report that the anticipation is worse than the procedure itself. The operation typically takes 45 to 60 minutes. You should be back with family within a couple of hours.

Q15. What is the recovery period like?

Most patients experience a temporary drop in central vision immediately after surgery. This usually recovers within a few weeks. A change in your glasses prescription is common and will be assessed once the eye has stabilised.

Your doctor will see you the day after surgery. You will likely wear an eye patch overnight and have it removed the next morning. Follow-up visits are more frequent in the first few weeks, then become less so as your eye stabilises.

You will be prescribed antibiotic and steroid drops. Some of your glaucoma medications may be continued during the early post-operative period.

Q16. Do I need to restrict activity after surgery?

Gentle walking is encouraged soon after surgery, your doctor will recommend it. For the first week, wear an eye shield at night to protect the eye.

  • Return to desk work: approximately two weeks.
  • Strenuous exercise or weight lifting: avoid for at least one month.
  • Swimming: avoid for at least one month.

📌 Always follow your surgeon’s specific instructions. Recovery timelines can vary depending on the type of surgery and how your eye responds.

Q17. What are the risks of glaucoma surgery?

Your doctor has weighed the risks against the risk of untreated glaucoma progression before recommending surgery. The main risks to be aware of include:

  • Temporary vision drop: Reduced central vision in the early post-operative period due to inflammation, pressure fluctuations, or bleeding. This usually resolves within weeks.
  • Cataract: The risk of cataract development increases after glaucoma surgery, and pre-existing cataract may progress faster.
  • Infection: As with any surgery, there is an increased risk of infection. With trabeculectomy, this risk remains elevated long-term due to the presence of the bleb.
  • Need for additional procedures: A further procedure or surgery may be needed to optimise pressure control.

📌 Knowing the risks allows you to monitor for early signs and report them promptly. Most complications are manageable when caught early.

If you would like a structured glaucoma risk assessment or second opinion:

+91 88826 38735
drshibalbhartiya.com

Upload your reports for a structured review.

Read the research articles

This article has been written by Dr Shibal Bhartiya, a glaucoma specialist in Gurgaon known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also a research collaborator with Mayo Clinic, Jacksonville, Florida, USA.

She has published peer-reviewed research on glaucoma laser and surgeries, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

These peer-reviewed article discussing glaucoma treatment are benchmarks for glaucoma surgeons globally, and can be accessed on PubMed and Google Scholar

If you would like a structured glaucoma risk assessment or second opinion:

+91 88826 38735
drshibalbhartiya.com

Upload your reports for a structured review.

Types of Glaucoma: Open Angle, Closed Angle, Normal Tension, and More

Types of Glaucoma: Open Angle, Closed Angle, Normal Tension, and More, explained by Dr Shibal Bhartiya, glaucoma specialist in Gurgaon.

Glaucoma is not a single disease. It is a family of conditions, each with different causes, risk factors, and treatment approaches. What they share is a common outcome: damage to the optic nerve, leading to progressive and irreversible vision loss if untreated.

Understanding which type of glaucoma you have helps you ask better questions and follow your treatment plan with more confidence. This page explains the main types, from the most common to the less well known, written for patients rather than clinicians.

Dr Shibal Bhartiya is a fellowship-trained glaucoma specialist in Gurgaon with experience diagnosing and managing all types and stages of glaucoma. If you are uncertain about your diagnosis, a structured second opinion can bring clarity.

THE TWO MAIN TYPES OF GLAUCOMA

Q1. What is the difference between open-angle and closed-angle glaucoma?

Most glaucomas fall into one of two broad categories, determined by the anatomy of the drainage angle of the eye.

Open-angle glaucoma is by far the more common type of glaucoma. The drainage angle is open and appears normal, but fluid drains too slowly, causing pressure to build gradually over months and years. It has no symptoms in the early stages. Patients typically lose peripheral vision first, and the brain compensates so well that many people do not notice the loss until the disease is advanced. This is why regular screening is essential, particularly for those with risk factors.

Closed-angle glaucoma occurs when the drainage angle is narrow or blocked, preventing fluid from draining. It can occur suddenly (acute angle closure) or gradually (chronic angle closure). The acute form is a medical emergency with symptoms including severe eye pain, redness, blurred vision, and nausea. The chronic form is subtler and may mimic open-angle glaucoma.

Note: The distinction between the two types of glaucoma (open and closed angle) is made using a test called gonioscopy. This single test shapes all subsequent treatment decisions.

CLOSED-ANGLE GLAUCOMA

Q2. I have been diagnosed with angle-closure glaucoma. What does that mean for me?

In angle-closure glaucoma, the iris (the coloured part of the eye) is too close to the drainage angle, narrowing or blocking it. When the angle closes, fluid cannot drain and eye pressure rises sharply.

The acute form causes a sudden, severe rise in pressure. Symptoms include a red, painful eye with blurred vision, coloured halos around lights, headache, and nausea. This is an eye emergency; seek immediate medical help if this happens.

The chronic form builds more slowly, with few symptoms other than occasional coloured halos and mild headaches. It can go undetected for years without a formal eye examination.

Treatment for angle-closure glaucoma starts with a laser procedure called laser peripheral iridotomy (LPI). This creates a small opening in the iris to provide an alternative drainage pathway. After LPI, some patients require no further treatment; others need long-term eye drops. Your doctor will monitor your pressure and angle anatomy over time.

Note: Family members of patients with angle-closure glaucoma have a higher risk of the same condition. Preventive laser iridotomy can be offered to at-risk relatives before any acute episode occurs.

NORMAL TENSION GLAUCOMA

Q3. My doctor says I have glaucoma, but my eye pressures are normal. How is that possible?

This is understandably confusing. Between 10 and 25 percent of people with glaucoma have eye pressures that fall within the normal range (below 21 mmHg). This is called normal tension glaucoma (NTG), or low tension glaucoma.

The exact cause is not fully understood. Two leading theories are that the optic nerve is unusually sensitive to pressure and sustains damage even at pressures that would be harmless in most people, or that the blood supply to the optic nerve is compromised, making it vulnerable to damage independent of pressure. Of all the types of glaucoma, this is perhaps the most confusing for patients.

Conditions associated with normal tension glaucoma include:

  • Japanese ancestry (NTG is significantly more common in East Asian populations)
  • A family history of normal tension glaucoma
  • Migraines and vasospastic disorders such as Raynaud’s disease
  • Sleep apnoea
  • Alzheimer’s disease

Treatment still focuses on lowering eye pressure, like all other types of glaucoma. Even when eye pressure is within the normal range to start with, clinical trials have shown this slows progression. Eye drops, laser, or surgery may be used depending on the rate of progression and individual risk factors.

Note: Normal tension glaucoma often progresses more slowly than high-pressure glaucoma, but regular monitoring is still essential. Missing follow-up appointments is the most common reason for avoidable vision loss.

OCULAR HYPERTENSION

Q4. My eye pressures are high but my doctor says I do not have glaucoma. What is ocular hypertension?

If your eye pressure is above the normal range but your optic nerve and visual field show no signs of damage, you have ocular hypertension (OHT). It is not glaucoma, but it is a significant risk factor for developing glaucoma.

Not everyone with high eye pressure will develop glaucoma. Your individual risk depends on your age, ethnicity, family history, and corneal thickness (thicker corneas can give falsely high pressure readings).

Your doctor will weigh your risk profile before deciding whether to treat. Options include eye drops or selective laser trabeculoplasty (SLT). In lower-risk patients, careful monitoring without treatment is often appropriate, since all glaucoma medications carry some side effect burden.

Whether or not you receive treatment, regular eye checks are essential. The goal is to detect any optic nerve or visual field changes before significant vision is lost.

GLAUCOMA SUSPECT

Q5. My doctor says I am a glaucoma suspect. My tests were normal. Why do I still need annual monitoring?

A glaucoma suspect is someone whose optic nerve appearance raises concern, even when eye pressure and visual field tests are currently normal.

The most common reason is a larger than average cup-to-disc ratio (the proportion of the optic nerve head occupied by the central cup). A ratio above 0.5, or a difference of 20 percent or more between the two eyes, warrants closer monitoring. Other reasons include borderline eye pressures or a strong family history of glaucoma.

This does not mean you have glaucoma. It means your doctor wants a baseline record to compare against over time. If the optic nerve or visual field changes, that change can be detected early and treatment started before significant vision is lost.

Most glaucoma suspects are asked to return for annual or biannual testing. Once several years of stable results have been recorded, the interval between visits may be extended.

Note: The value of being labelled a glaucoma suspect is that it keeps you in the system. Early detection is the single most powerful tool for preventing glaucoma blindness.

SECONDARY GLAUCOMA

Q6. What is secondary glaucoma, and what causes it?

Secondary glaucoma is glaucoma caused by another identifiable condition or event, rather than arising on its own. It is managed in the same way as primary glaucoma (eye drops, laser, or surgery), but the underlying cause must also be addressed.

The most common secondary types of glaucoma include:

  • Pseudoexfoliation glaucoma: A protein-like material deposits on the lens and drainage structures of the eye, blocking outflow. This is one of the most common secondary glaucomas in India and tends to cause higher pressures and faster progression than primary open-angle glaucoma. It requires close monitoring and often more aggressive treatment.
  • Pigmentary glaucoma: Pigment granules shed from the back of the iris clog the drainage angle. It typically affects younger, myopic (short-sighted) patients and is often missed because these patients are not in the standard high-risk age group for glaucoma screening.
  • Steroid-induced glaucoma: Long-term use of steroid eye drops, nasal sprays, skin creams, or oral steroids can raise eye pressure in susceptible individuals. If you are on any form of steroid medication for any condition, ask your doctor whether your eye pressure has been checked.
  • Traumatic glaucoma: An injury to the eye can damage the drainage angle and cause pressure to rise, sometimes years after the original injury. Any history of significant eye trauma should be disclosed to your eye doctor.
  • Neovascular glaucoma: New, abnormal blood vessels grow over the drainage angle, blocking outflow. It is most commonly associated with poorly controlled diabetes and retinal vein occlusion. It is one of the more difficult types to manage and often requires surgery.

Note: If you have a systemic condition such as diabetes, or are on long-term steroid medication, make sure your eye doctor is aware. These are glaucoma risk factors that are often overlooked.

CONGENITAL AND CHILDHOOD GLAUCOMA

Q7. My child has been diagnosed with glaucoma. How is that possible, and what should I expect?

Glaucoma can affect any age group, though it is most common in adults over 40. In children, the most common cause is a structural defect in the drainage angle that is present from birth; this is called congenital glaucoma or primary infantile glaucoma.

Signs that parents typically notice first include:

  • Cloudy or hazy eyes
  • Unusual sensitivity to light; the child may turn away from bright light or bury their face
  • Excessive tearing
  • Eyes that appear larger than normal (because raised pressure causes the infant eye to expand)

Eye drops may be started initially to control pressure, but surgery is almost always required for congenital glaucoma. Early surgical intervention gives the best chance of preserving good vision throughout the child’s life.

Some children also have a co-existing cataract or other eye abnormality that needs to be managed alongside the glaucoma. Glasses, patching therapy for amblyopia (lazy eye), and follow-up surgeries may all be part of the long-term plan.

Children with glaucoma can lead fully independent lives. Even where some vision has been lost, tailored rehabilitation and visual aids allow children to participate in all age-appropriate activities. As a parent, remaining engaged with the care team and encouraging the child’s independence are the most important things you can do.

Note: Congenital glaucoma is rare. If your child has been diagnosed, seek care from a specialist with specific paediatric glaucoma experience. Early and consistent follow-up is critical.

Read the research articles

This article has been written by Dr Shibal Bhartiya, a glaucoma specialist in Gurgaon known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. She is also a research collaborator with Mayo Clinic, Jacksonville, Florida, USA.

She has published peer-reviewed research on glaucoma laser and surgeries, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

These peer-reviewed article discussing glaucoma treatment are benchmarks for glaucoma surgeons globally, and can be accessed on PubMed and Google Scholar

If you would like a structured glaucoma risk assessment or second opinion:

+91 88826 38735
drshibalbhartiya.com

Upload your reports for a structured review.