Glaucoma is a term that many people are still not familiar with. This is mainly because of the lack of awareness in community regarding this insidious disease. However, it is one of the world’s leading causes of irreversible blindness. It is a disease that often does not show any symptoms until much later, when irreversible damage and visual loss have occurred. Hence, it is also known as the silent thief of sight.
Leaving glaucoma too long
During a routine screening, Mr Shafiq* (not his real name), 45, was found to have glaucoma in both eyes. His eye doctor started him on pressure-lowering eyedrops. However, since he did not feel any eye symptoms, and could not see how the eyedrops were helping his vision, Mr Shafiq stopped using the eyedrops after a few months.
Twelve years later, Mr Shafiq complained of blur vision in both eyes. His glaucoma had developed into advanced glaucoma and cataracts. Hence, he underwent an operation to address both the cataracts and glaucoma; first in his right eye followed by his left.
Even though, his vision became clearer after the cataract removal, Mr Shafiq had very limited field of vision due to his advanced glaucoma. The condition prevented him from doing many activities. He could not even drive anymore. When he consulted his doctors for treatment to regain his full vision, he was informed that due to glaucoma, his visual defects were irreversible.
Exact cause is unknown
There are many types of glaucoma all of which result in damage to the optic nerve. The role of this nerve is to bring visual information from our eyes to our brain so that we can decipher what we see. This damage causes corresponding visual field loss in the affected individual that eventually leads to total blindness.
Although the exact cause and pathological process of glaucoma disease is unknown, glaucoma has a definite link to eye (intraocular) pressure. We all have eye pressure, just like we have blood pressure. A buildup of pressure within the eye damages the optic nerve. The longer the pressure buildup persists, the worse the damage is to the nerve. Thus, most treatment strategies for glaucoma aim to reduce the intraocular pressure in order to control the progression of this disease.
Various types of treatment
In the initial stages, eye doctors will usually start the patient on pressure-lowering eyedrops. Following that, there are many other types of treatments depending on the type and severity of the glaucoma. These include oral medications, lasers, surgeries, and ultrasound.
Today, there is a new type of treatment available comprising different types of microdevices that are inserted into the eyes using minimally invasive techniques to reduce pressure. All these treatment modalities help to control the intraocular pressure and help reduce the progression of glaucoma.
Eye screening is vital
Although numerous treatment options are available in these modern times, glaucoma is still an incurable disease that requires lifelong treatment. The earlier it is discovered, the better the long-term outcome. Thus, it is crucial to first identify the presence of this disease.
This can be done by seeing an eye doctor for a routine eye screening session. It is important for adults above 40 years of age to regularly check their eyes for glaucoma every one to two years. For people with increased risk of glaucoma, such as those with a family member with glaucoma, this screening should be done every year, at the very least.
Glaucoma patients often ask what they can do in their everyday life to reduce the chances of losing vision due to this insidious disease. Once diagnosed with glaucoma, it is crucial to follow up regularly with your eye doctor. The eye doctor will monitor the progression of the disease with visual field tests, eye pressure measurements and special scans for the optic nerve called optical coherence tomography. It is also very important to be adherent to the prescribed eyedrops.
Underlying factors leading to glaucoma
Apart from the above, tackling certain risk factors associated with glaucoma may also help to control the progression of the disease. Underlying systemic diseases such as diabetes and hypertension may cause glaucoma to progress faster. Thus, good sugar control and pressure control are essential. Other lifestyle changes that may help are aerobic exercises, quitting smoking and reducing caffeine intake. It is also important to get treated for specific conditions such as sleep apnea which is associated with glaucoma.
Although a serious condition, with early diagnosis and proper treatment, glaucoma can be well controlled without progressing to blindness. Glaucoma management aims to maintain functional vision of the eyes that exceeds their lifespan. Thus, it is crucial to get annual eye examinations and adhere to the treatment regime as prescribed. With many more advanced treatment options being currently developed, we can expect an even better future for the treatment of glaucoma. Let’s protect our eyes from this thief of sight so we can continue to appreciate the beauty of this world.
Written by
Dr. Sudhashini Chandrasekaran
Consultant Ophthalmologist
Columbia Asia Hospital – Puchong
