Hello Again, This month provides a fresh new opportunity to understand a silent ocular disease known as Glaucoma, commonly referred to as the ‘Thief of Sight’. It is a group of disparagingly insidious eye conditions that manifests upon us without any prior warning. It believes in the power of Stealth and Silence and predominantly pounces upon us unexpectedly. March 07th – 13th has been designated as the World Glaucoma Awareness Week. So advanced and precarious is its advent that it was deemed fit by the Worldwide Ocular Community to actually highlight its consequences in order for the larger public not to be caught unawares. Today, we will touch on the subject and underscore the importance of getting your eyes checked for this debilitating disease, especially if you have reached the prime age of 40 years and above. Without further ado, lets embark on the journey of briefly understanding what Glaucoma is
So, what is Glaucoma?
Glaucoma is a disease that damages the Optic Nerve at the point where it leaves the eye. This nerve carries information from the light sensitive layer in your eye [the retina], to the brain where it is perceived as a picture. In a healthy eye, a clear liquid in the anterior chamber [the front portion of the eye] flows flawlessly through the drainage system. This clear liquid provides nutrients to eye tissues and maintains the eye in a balanced pressurized state. When this liquid does not flow properly through the drainage system, fluid pressure builds up and presses onto the optic nerve, causing damage to the nerve fibers. Lower levels of built-up pressure can cause damage slowly, whereas really high built-up pressure damages the optic nerve immediately; and sometimes permanently. It is important to be note that Eye pressure is largely independent of blood pressure. To understand the disease properly, lets briefly examine the different types of Glaucoma that present as potential threat to our vision.
Types of Glaucoma
There are basically four main types of Glaucoma.
Chronic or Open Angle Glaucoma: The Drainage channels gets blocked slowly over many years, giving rise to a measured increase in eye pressure. No pain is experienced but the field of vision starts becoming gradually impaired.
Acute or Closed Angle Glaucoma: A sudden and complete blockage of the aqueous fluid- flow to the drainage channel. In Acute Glaucoma, the elevated eye pressure causes piercing pain, red eyes and rapid deterioration of sight. This might be accompanied by a blackout, nausea, vomiting and misty rainbow rings around white lights. This may result in permanent damage if not treated properly.
Secondary Glaucoma: A rise in eye pressure caused by other conditions like; use of steroid-containing eye drops, injections & pills, pigmentary granules from the Iris, Uveitis, trauma etc. Others are: Family History, Thinner than usual corneas, Diabetes, Sickle Cell anemia or elevated Inter Ocular Pressure [IOP].
Congenital Glaucoma: Caused by malformation of the eye, like poor development of the angle of the eyes, mainly at birth. This restricts the flow of aqueous humour, thereby elevating the pressure build-up in the eye(s). Hazy eyes, especially in infants is an indicator of this condition and should be considered as a red flag. Evaluation of the eyes should become a priority for parents who notice this in their children, particularly the new born.
Glaucoma becomes more common with increasing age. It is imperative that once you cross over the age of 45 years, your Intra Ocular Pressure needs to checked periodically and a retinal exam [Funduscopy] be conducted by an eyecare professional. Family History plays a pivotal role in Chronic Glaucoma and it is advisable for all members of the Family to have these tests done every year. What happens as Glaucoma advances and what does the vision look like?Glaucoma induced Vision loss has traditionally been described as loss of “peripheral vision” or loss of vision at the outer edges. As untreated Glaucoma progresses, so does the diminishing of peripheral vision. The fields of vision reduce dramatically over the years resulting in a condition known as ‘Tunnel Vision’. Apart from impacting our overall orientations, the progressively reducing peripheral vision inhibits our ability to drive, affects night vision, bumping into objects, navigating in crowded places, falling, and performing other important tasks encountered in our daily lifestyle. Below are some self-explanatory pictures that will give a general idea of Normal Vision and the effects of the progression of Glaucoma. So, if in doubt; don’t delay have an eye test today.
Vision loss can be prevented only if the condition is detected before the eye pressure causes damage to the optic nerve. Treatment involves controlling the pressure in the eye using eyedrops, drugs followed by laser treatment or surgery which allows the drainage system to open up. Please remember; that early diagnosis is the key. Advanced condition results in sight loss and cannot be reversed. Damage done cannot be repaired. In a nutshell….
Ensure that your eye exams consist of more than the standard Vision test. Glaucoma [IOP] test and Funduscopy must be carried out if you have reached the age of 45 years.
Be mindful of the symptoms identified above and immediately seek professional help from your Optometrist or an Ophthalmologist.
If there is a Family History of Glaucoma, be more careful and insist on a proper ocular evaluation. If your Optometrist is unable to carry out this test, seek alternative means.
If you experience sudden blurriness of Vision associated with severe eye pain and red eyes, don’t delay, seek medical intervention immediately.
Observe Infants for hazy, painful red eyes. If in doubt seek medical help.
You can’t prevent glaucoma. But if you find it early, you can lower your risk of eye damage. These steps may help protect your vision:
Regular eye exams is the Key: Adults over the age of 40-45 need to be checked every 3-5 years. If you have a family history of Glaucoma or any other underlying disease like Retinitis Pigmentosa, Scotoma, Stroke, Diabetic Retinopathy and in some cases even Migraine with an aura, you need to be checked more often.
Follow instructions: If high intra ocular pressure is established, you will need to be on eyedrops that manage the condition. A strict medication discipline needs to be followed if diagnosed as prescribed by your eyecare practitioner.
Family history: Enquire from your family members or relatives whether any of them have been diagnosed with glaucoma.
Regular Exercise: Moderate activity like walking or jogging at least three times a week will greatly assist to keep glaucoma at bay.
Protect your eyes: Protective eyewear helps reduce trauma causing eye accidents whilst playing sports or working on home improvement projects.
I wish you Crystal Clear Vision and encourage you to get your eye exam done by an experienced eyecare professional at all times.