| What does the abbreviation NPCB stand for? | National Programme for Control of Blindness | Perimetry + baseline IOP (preferably morning and evening) to determine ‘Target’ IOP TONOMETRY (repeat twice) + Gonioscopy BE Yag PI ESSENTIAL Slit lamp bio microscopy, AC Depth, gonioscopy, Pupillary reflex, Estimation of IOP (3 measurements), Visual field assessment DESIRABLE Diurnal variation. Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 490 | definition | 0.980 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 1 | page=1,block=68 | 0.700 | valid |
| What is the purpose of counselling after glaucoma surgery? | to lower IOP to stabilize the disease. | The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up TERTIARY CARE • Detailed work up as above • Optional investigations such UBM, OCT, HRT, GCC for RNFL thickness when necessary • Surgical intervention, YAG Pi, Trabeculectomy, any other advanced procedure such as tube shunts. • Ensure Postoperative Follow up and compliance including collaboration with district hospital ophthalmologists • Counselling regarding spacing and phasing of glaucoma medication and reporting of side effects if any. • Counsel that surgery is not a cure but a means to lower IOP to stabilize the disease. | 636 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | • Counsel that surgery is not a cure but a means to lower IOP to stabilize the disease. | 1 | page=1,block=39 | 0.700 | valid |
| What is the purpose of counselling regarding surgery in glaucoma management? | surgery is not a cure but a means to lower IOP to stabilize the disease. | The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up TERTIARY CARE • Detailed work up as above • Optional investigations such UBM, OCT, HRT, GCC for RNFL thickness when necessary • Surgical intervention, YAG Pi, Trabeculectomy, any other advanced procedure such as tube shunts. • Ensure Postoperative Follow up and compliance including collaboration with district hospital ophthalmologists • Counselling regarding spacing and phasing of glaucoma medication and reporting of side effects if any. • Counsel that surgery is not a cure but a means to lower IOP to stabilize the disease. | 602 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | • Counsel that surgery is not a cure but a means to lower IOP to stabilize the disease. | 1 | page=1,block=39 | 0.700 | valid |
| What is the aim of glaucoma management? | Achieve target IOP with minimal fluctuation | The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up INDICATIONS FOR SURGERY • IOP above target despite maximal tolerated medical therapy • Inability to review regularly • Unable to affford medications • Progession of the disease on maximal tolerated medical therapy • Non compliance Intervention: Consult flowchart, pre-op topical broad spectrum antibiotics, QID for 1-3 days Aim of Glaucoma Management • Achieve target IOP with minimal fluctuation (Refer NPCB Guidelines) • Iridotomy in all primary angle closure patients • Trabeculectomy or referal to higher center if target IOP not achievable Special instruction for glaucoma medication: • Punctal Occlusion’ • Not to squeeze eyesafter instillation • 1 drop in conjunctival sac QUALITY ASSESSMENT • Patient identifier, Age/ Gender • Compliance with Follow up schedule and medications *if normal but associated with other features think of normal-tension glaucoma | 498 | summary | 0.930 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up INDICATIONS FOR SURGERY • IOP above target despite maximal tolerated medical therapy • Inability to review regularly • Unable to affford medications • Progession of the disease on maximal tolerated medical therapy • Non compliance Intervention: Consult flowchart, pre-op topical broad spectrum antibiotics, QID for 1-3 days Aim of Glaucoma Management • Achieve target IOP with minimal fluctuation (Refer NPCB Guidelines) • Iridotomy in all primary angle |
| What does the abbreviation OCT stand for? | Optical coherence tomography | Perimetry + baseline IOP (preferably morning and evening) to determine ‘Target’ IOP TONOMETRY (repeat twice) + Gonioscopy BE Yag PI ESSENTIAL Slit lamp bio microscopy, AC Depth, gonioscopy, Pupillary reflex, Estimation of IOP (3 measurements), Visual field assessment DESIRABLE Diurnal variation. Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 455 | definition | 0.900 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 1 | page=1,block=68 |
| What does the abbreviation RNFL stand for? | Retinal nerve fiber layer | Perimetry + baseline IOP (preferably morning and evening) to determine ‘Target’ IOP TONOMETRY (repeat twice) + Gonioscopy BE Yag PI ESSENTIAL Slit lamp bio microscopy, AC Depth, gonioscopy, Pupillary reflex, Estimation of IOP (3 measurements), Visual field assessment DESIRABLE Diurnal variation. Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 600 | definition | 0.900 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 1 | page=1,block=68 |
| What does the abbreviation UBM stand for? | High-frequency ultrasound biomicroscopy | Perimetry + baseline IOP (preferably morning and evening) to determine ‘Target’ IOP TONOMETRY (repeat twice) + Gonioscopy BE Yag PI ESSENTIAL Slit lamp bio microscopy, AC Depth, gonioscopy, Pupillary reflex, Estimation of IOP (3 measurements), Visual field assessment DESIRABLE Diurnal variation. Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 631 | definition | 0.900 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | Central Corneal thickness OPTIONAL UBM, OCT, HRT, GCC for RNFLthickness AC: Anterior chamber GCC: Ganglion cell complex HRT: Heidelberg retina tomograph OCT: Optical coherence tomography NPCB: National Programme for Control of Blindness PI: Peripheral iridectomy POAG: Primary open angle glaucoma RNFL: Retinal nerve fiber layer UBM: High-frequency ultrasound biomicroscopy | 1 |
| What advanced procedures are mentioned for tertiary care in glaucoma management? | YAG Pi, Trabeculectomy, any other advanced procedure such as tube shunts. | The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up TERTIARY CARE • Detailed work up as above • Optional investigations such UBM, OCT, HRT, GCC for RNFL thickness when necessary • Surgical intervention, YAG Pi, Trabeculectomy, any other advanced procedure such as tube shunts. • Ensure Postoperative Follow up and compliance including collaboration with district hospital ophthalmologists • Counselling regarding spacing and phasing of glaucoma medication and reporting of side effects if any. • Counsel that surgery is not a cure but a means to lower IOP to stabilize the disease. | 296 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up TERTIARY CARE • Detailed work up as above • Optional investigations such UBM, OCT, HRT, GCC for RNFL thickness when necessary • Surgical intervention, YAG Pi, Trabeculectomy, any other advanced procedure such as tube shunts. • Ensure Postoperative Follow up and compliance including collaboration with district hospital ophthalmologists • Counselling regarding spacing and phasing of glaucoma medication and reporting of side effects if any. |
| What are some of the diagnostic procedures performed at a district hospital for glaucoma? | Slit lamp examination& AC Depth , IOP, Optic nerve head examn • Gonioscopy ,fields | DISTRICT HOSPITAL • Refraction for BCVA • Detailed work up including, Slit lamp examination& AC Depth , IOP, Optic nerve head examn • Gonioscopy ,fields and Diagnose, classify, advice as per Flow chart. point to point guided referral • Surgical intervention such as Yag PI and Trabeculectomy • Counselling regarding spacing and phasing of glaucoma medication and reporting of side effects if any. • Counsel that surgery is not a cure but a means to lower IOP to stabilize the disease. The follow up is mandatory and will remain, regardless • Counsel that stabilization of disease is available with regular treatment and follow up | 70 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | DISTRICT HOSPITAL • Refraction for BCVA • Detailed work up including, Slit lamp examination& AC Depth , IOP, Optic nerve head examn • Gonioscopy ,fields and Diagnose, classify, advice as per Flow chart. | 1 | page=1,block=36 | 0.700 | valid |
| What are some optic nerve head abnormalities that require screening for glaucoma? | Cup to disc ratio > 0.7; asymmetry > 0.2 | Glaucoma can be asymptomatic Can lead to irreversible vision loss if not treated in time Everybody ≥ 40 years age to be screened • Abnormalities of optic nerve head(Cup to disc ratio > 0.7; asymmetry > 0.2) • IOP* >20mmHg • Evidence of ocular co-morbidities that could lead to secondary glaucoma • Torch light examination : on shadow test - shallow anterior chamber and Iris changes (Iris atrophy and sphincter pupil atrophy) • Visual field defects • Evidence of previous surgery or laser • Evidence of intermittent angle closure glaucoma SIGNS HISTORY TAKING • Unilateral intermittent headache, blurring of vision, eye pain, coloured haloes • Previously diagnosed /glaucoma suspect • Treatment history - medical/surgical/laser and compliance with medication/follow up | 165 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569102_glaucoma.pdf | Glaucoma can be asymptomatic Can lead to irreversible vision loss if not treated in time Everybody ≥ 40 years age to be screened • Abnormalities of optic nerve head(Cup to disc ratio > 0.7; asymmetry > 0.2) • IOP* >20mmHg • Evidence of ocular co-morbidities that could lead to secondary glaucoma • Torch light examination : on shadow test - shallow anterior chamber and Iris changes (Iris atrophy and sphincter pupil atrophy) • Visual field defects • Evidence of previous surgery or laser • Evidence of intermittent angle closure glaucoma SIGNS HISTORY TAKING • Unilateral intermittent headache, |