"Health Watch"



*Dr. Anu Munshi-Khandhar

We would like to thank all the Shehjar readers for sending in so many interesting health related questions. We will do our best to answer all of them.
Question – Could you please tell me a little bit about the course of glaucoma once diagnosed? What are the surgical treatments, etc.? - O.N. Wali
Answer – Glaucoma basically means having high pressure inside the eye which can thus affect the optic nerve. There is an imbalance of production of fluid (aqueous humor) in the eye and its drainage, which therefore leads to increased pressure. If not diagnosed or treated properly, it can lead to vision loss.

There are two different types of glaucoma – open angle and closure-angle. In angle closure glaucoma, the drainage system is physically blocked, therefore causing increased pressure. If this happens acutely (suddenly), it can be an emergency because vision could be lost within hours of onset. In open angle, the drainage system is not blocked. Open angle glaucoma can also lead to blindness if not treated.

Most people do not seek treatment for glaucoma because initially there are no symptoms. People go to their eye doctor once they have started having some significant vision loss. Other symptoms of glaucoma can be blurred vision, headaches, halos around lights, etc. This is why it is important to see your optometrist or ophthalmologist once a year or more depending on the health of your eyes.

You should go see the eye doctor immediately if you ever experience sudden loss of vision, especially your peripheral (side) vision.

The goal of glaucoma treatment is to lower the intraocular pressure (IOP). This can be done using medications and sometimes requires surgery. Surgery, most commonly laser iridotomy, is usually performed for angle closure glaucoma. During this procedure, a focused beam of light is basically used to create a hole in the iris (the colored part of the eye) to help drain the fluid. It is an outpatient procedure and takes just a few minutes. Your doctor will give you some eye drops and have you follow up within a day or week of the procedure. Potential complications include infections, bleeding, and transient elevation of eye pressure.

There is no sure way to prevent glaucoma from occurring and there is no cure, only chronic management of the disease. It is best to be detected early via annual visits to the eye doctor. It is so important to make early detection of such manageable diseases – you can at least prevent blindness! Why not make it a family event and schedule an appointment for everyone today?

Question - My mother is a patient of idiopathic pulmonary fibrosis in age profile of 70+. She is being treated with usual dosages of steroids, mild antibiotics, nebulizer and oxygen through oxygen concentrator, vitamins and combination of amino acids are some other efficiency enhancers.
I have certain queries regarding the latest development regarding this disease. Are their any natural drugs like Nuprinol available at your place? This drug seems to digest the thick fibre around alveoli, preventing further spread. I am not sure how far it is applicable or else educate me with the latest updates. Also educate me what are the best preventive care available for such patients. Do brief me about the balanced diet to be given to such patients in order to leverage their strength.
- A. Raina, India
Answer – For the benefit of the general population, let me briefly explain what idiopathic pulmonary fibrosis is. IPF basically means scarring of the tissues of the lungs. This scarring over time leads to stiffened and thick lung tissue which prevents oxygen from entering the blood stream. There are a few known causes of pulmonary fibrosis, but when the cause is not known, it is called “idiopathic”, hence IPF. The course of this disease varies from person to person, but in general starts with shortness of breath. Only your doctor (likely a pulmonologist) will be able to diagnose this disease.

In regards to your question about treatment of IPF – this will also vary from patient to patient but generally involves steroids for decreasing inflammation, cytoxan for immune suppression, and oxygen. Pulmonary rehabilitation which includes exercise training and breathing exercises is also beneficial. A last resort is lung transplantation; however, this is not without its risks and age/quality of life should be taken into consideration. There are many drugs being tested for the treatment of IPF, but they are still in the experimental stages. Some of the drugs that are being used or are still in experimental stages are N-Acetylcysteine, Pirfenidone, Prostaglandin E2, endothelin receptor antagonists (called Bosentan in USA), and anti-tumor necrosis factor alpha therapy. I recommend that you discuss these with the pulmonologist. In terms of diet, there is no specific diet recommended, but of course, we always suggest a healthy and balanced one.

It is also important to avoid things such as smoke from cigarettes (even second hand smoke), pollution and dust. It can also be difficult to clear infections from the lung and it is important to take efforts to prevent them from happening. It may be a good idea to get pneumonia and flu vaccines and also to see your doctor immediately if you feel yourself getting sick.

It is not the intention of Shehjar to replace your physician, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and we urge you to consult with a qualified physician for diagnosis and for answers to your personal questions.

*Anu Munshi-Khandhar was born and partly raised in Kashmir. She moved with her family to the USA during the mass exodus of Kashmiris in 1990. She currently lives in Pittsburgh with her husband and works at the Critical Care Department at University of Pittsburgh Medical Center.

She is very passionate about social service, global health and preventive medicine. Her other interests are hindi music, writing and pencil sketching.

Please email us at for any health related questions. We can publish them anonymously at your request.
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