A FEW MINUTES CHECK COULD SAVE YOU FROM BLINDNESS

As recent as 2010, the World Health Organization (WHO) estimated that 285 million people were visually impaired. Of these numbers, 39 million were blind.  Presently, 4.5 million (about 15 per cent) of the world’s blind population are blind as a result of glaucoma. This has raised concerns globally about this disease which has been termed the second leading cause of blindness in the world. In fact, the WHO categorizes it as one of the priority eye diseases plaguing the world today.

How glaucoma works

Experts explain that there is a small space in the front of the eye called the anterior chamber. Clear liquid flows in and out of the anterior chamber and this fluid nourishes and bathes nearby tissues. If a patient has glaucoma, the fluid does not drain properly— it drains too slowly — out of the eye. This leads to fluid build-up and pressure inside the eye rises. Unless this pressure is brought down and controlled, the optic nerve and other parts of the eye may become damaged, leading to loss of vision.

According to Dr. Idris Babatunde, an ophthalmologist, “Glaucoma is not just a single disease, but is a group of disorders that have certain features in common. One is that there is damage to the optic nerve which leads to progressive, irreversible loss of vision. Also, there is usually increased pressure of the fluid in the eye (intra ocular pressure).”

Why glaucoma is a huge concern

Besides the fact that it has no symptoms as the disease progresses until it gets to a point of no return, in the world today, glaucoma is the second leading cause of blindness, followed by cataracts. However, while blindness from cataracts is reversible, blindness from glaucoma is irreversible. In other words, glaucoma is the leading cause of irreversible blindness in the world today.

Am I at risk of having glaucoma?

Certain factors predispose a person to having glaucoma. According to Fatima Kyari of the Department of Ophthalmology, College of Health Sciences, University of Abuja, gender is not consistently associated with prevalent cases of glaucoma but age is an important and consistent risk factor, with a higher prevalence of glaucoma associated with increasing age. Other risk factors especially for open angle glaucoma according to her include increasing age, higher internal ocular pressure (IOP), lower systolic blood pressure (BP) to IOP ratio (BP/IOP), lower mean diastolic ocular perfusion pressure (diastolic BP minus IOP), thinner central corneal thickness (CCT), and a positive family history.

Although increasing age is a risk factor, experts have pointed out that in recent times, young people have also been known to have glaucoma.

Regarding heredity, an ophthalmologist, Dr Ben Ajayi, of Ojulowo Eye Hospital, Ibadan, Oyo State, says “in some cases, hereditary factors have been found but they are in the minority. The fact that either or both parents have glaucoma doesn’t mean all the children would have it. This means that there might be environmental factors that modify the presentation of glaucoma.”

How do I know I have glaucoma?

The sad thing with glaucoma is that it does not have any symptom and this is why it is referred to as the silent thief of sight. Dr Ajayi says, “unfortunately, glaucoma has no symptoms and the most vulnerable people are those who think they have no eye problems. It is not just for the old and the sad part is that people who have it usually don’t even know they have it until their sight becomes affected. By the time there is vision loss, it is actually already too late. Whereas, if they had had periodic eye exam, it could have been detected before vision loss occurs.”

However, eye doctors at the Maxivision Eye Hospital, Lagos State, say some symptoms which present when a person already has glaucoma includes blurred vision, severe eye pain, headaches, halos (which may appear as rainbows) around bright lights.

Can glaucoma be prevented or treated?

According to Dr. Babatunde, “presently, there is no known preventive measure for glaucoma. But if it is diagnosed early, there are treatments that can prevent blindness. Otherwise, the progression of the disease would eventually lead to blindness which is irreversible.” This is why periodic eye exam is very important.

The link between blood pressure and glaucoma

Regular eye exam is important to discover glaucoma in its early stages but it is more important for those with high blood pressure. According to Dr. Ajayi, “There is a link between blood pressure and glaucoma but the link is not well-defined. However, it’s a known medical fact that with patients who have severe hypertension and glaucoma, immediately the blood pressure is lowered too much, they can go blind. This is why for hypertensive patients with glaucoma, the ophthalmologist works closely with their primary physician. However, it’s not that hypertension causes glaucoma or vice versa.”

How long would an eye exam for glaucoma take?

Initial check-up is simple, painless and takes only a matter of minutes and this can be the defining moment for whether a person who unknowingly has glaucoma would eventually suffer blindness or not. This is because the earlier a patient is diagnosed with glaucoma, the better his/her chances for treatment and prolonged use of the eyes. The ophthalmologist checks the eye for structural change and functional deficit. According to Dr Ajayi, “functional deficit of the eye could be in the ability to see and recognize objects, the eye’s visual field (that is, if one eye is closed, how much can the person see around him with the other eye without turning his head) and ability to see colour. With glaucoma, colour vision is not commonly affected but the visual field is usually the first to be affected. An exam of the structure of the eye can provide clues to show that a person has glaucoma.”

If I am diagnosed with glaucoma, does that mean I’ll definitely go blind?

Not necessarily. If caught early, there is hope. But if allowed to fester to the point where there is already loss of vision, it can lead to blindness which is irreversible

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