Overview:
Dr. Manoj Sharma, a Professor of Social and Behavioral Health and Internal Medicine, answers queries on understanding and coping with early-stage glaucoma.
Manvinder’s story
Manvinder*, a 62-year-old college professor from Minnesota, went for a routine eye examination. His ophthalmologist told him that he had high intraocular pressure in his left eye and would need laser treatment. As a diabetic, he was worried about this diagnosis and approached us for advice.
Q: What is high intraocular pressure?
Dr. Sharma: Manvinder, high intraocular pressure (IOP), or ocular hypertension, means that the fluid pressure inside your eye is higher than the normal range, typically above 21 mm Hg, usually measured using tonometry. It indicates a potential imbalance in fluid drainage in the eye. If this happens, there is a greater risk of developing glaucoma, a sight-threatening eye disease in which the optic nerve can be damaged, leading to permanent vision loss.
Glaucoma prevalence is increasing from 2.8% in 2024 and is projected to be 3.5% by 2060, mainly due to the increasing age of the population. However, high IOP is a risk factor and not a disease per se, and since your ophthalmologist is recommending a remedial procedure, you should not worry too much about it.
Q: What could cause this condition?
Dr. Sharma: High IOP occurs when the aqueous humor, the clear fluid that fills the eye’s front chamber, cannot flow out of the eye normally. The aqueous humor nourishes the structures in the front of the eye, including the lens, and parts of the iris and cornea. It also maintains the eye pressure to keep the structure of the eye intact.
The drainage system that allows the aqueous humor fluid to drain from the eye must be clear to maintain normal IOP. When the fluid can no longer drain efficiently, it can build up, consequently increasing the eye pressure.
Q: Should I opt for the laser treatment?
Dr. Sharma: Yes, laser treatment is often used and highly recommended to treat high IOP. It is effective, usually performed in an office setting, and sometimes acts as a first-line therapy, enabling patients to reduce or eliminate dependence on daily eye drops.
Common laser procedures for high IOP are:
Selective Laser Trabeculoplasty (SLT): Often used for open-angle glaucoma to improve fluid drainage through the eye’s drainage tissue;
Laser Peripheral Iridotomy (LPI): Specifically for angle-closure glaucoma, this creates a tiny opening in the iris to improve fluid flow; and
Laser Cyclophotocoagulation: Reduces eye pressure by decreasing fluid production in the eye.
You can discuss the specific kind of laser procedure with your ophthalmologist before proceeding.
Q: What are the adverse effects of laser treatment?
Dr. Sharma: Immediately after the procedure, your eye may feel blurry, gritty, light-sensitive, or irritated for a few hours. Sometimes this could continue for a few days. Even though it is an office procedure, you may need someone to drive you home from the procedure. Your ophthalmologist may prescribe some anti-inflammatory drops.
Q: How will I know if I have developed glaucoma?
Dr. Sharma: Glaucoma has no symptoms in the early stages. Therefore, regular eye exams are extremely important. In late stages, blind spots in vision, headaches, eye pain, eye redness, etc., may be experienced.
People who have high IOP, are farsighted or nearsighted, use long-term steroids, have had an eye injury, have thin corneas, have thinning of the optic nerve, have diabetes, migraines or high blood pressure, are over 40 years of age, have a family history of glaucoma, and are of Asian, African, or Hispanic descent are at greater risk of developing glaucoma.
Q: Can yoga and meditation help with glaucoma?
Dr. Sharma: Yes, yoga and meditation can help manage glaucoma as complementary therapies. Studies suggest that consistent practice can lower intraocular pressure (IOP), reduce stress (cortisol), and improve quality of life, especially meditation (dhyana).
However, patients must avoid inverted yoga poses that increase eye pressure, such as headstand (shirshasana), downward dog pose (adho mukha svanasana), plow pose (halasana), or raised legs against the wall (viprita karani), etc.
Q: Can you share some additional resources?
Dr. Sharma: Here are some additional resources from which you can find more information:
- Cleveland Clinic’s website on glaucoma
- Mayo Clinic’s website on glaucoma
- Laser treatment for glaucoma from an Australian website
- Laser therapy for glaucoma
- Glaucoma Research Foundation: Is doing yoga safe if I have glaucoma?
If you have questions, reach out to Dr. Sharma at editor@indiacurrents.com
*Name changed upon request
