Dr Manoj Chandra Mathur
Glaucoma is the second leading cause of blindness globally yet and remains one of the most undertreated eye conditions. It is commonly known as the ‘silent thief of sight’ as it tends to show no early symptoms. Over time, people with glaucoma slowly loose vision, starting with their peripheral vision.
An increase in the pressure inside the eye, also known as intraocular pressure or Less Blood supply to Optic Nerve head leads to glaucoma which can cause irreversible vision loss and at times complete blindness if not treated properly. There are different types of glaucoma, but the most prevalent is Open Angle Glaucoma. According to a 2010 study, the estimated prevalence of open angle glaucoma cases in India is reported to be 11.9 million.
It is the most common form of glaucoma wherein the eye’s drainage channels become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve. It is particularly dangerous since Glaucoma in early stages mostly causes no symptoms. The nature of this condition delays early medical intervention and care.
Open angle glaucoma accounts for 90 percent of glaucoma cases. It occurs when the pressure inside the eye increases abnormally and damages the optic nerve. Another type of glaucoma is called angle closure glaucoma (ACG). Though it is somewhat less common, the symptoms are more acute.
There are not many warning signs that can tell if a person is developing glaucoma. The condition can progress for a long time without vision loss. By the time the patient experiences vision impairment, glaucoma progresses to an advanced stage. Being proactive and maintaining eye health by following the instructions of an ophthalmologist can prevent it from causing vision loss or blindness.
Many eye-related problems do not show clear symptoms or signs, and early diagnosis is the only way to detect and treat such conditions and maintain eye health. Knowing the family’s eye health history is a great way to be cautious, as diseases like glaucoma, and macular degeneration can be hereditary.
While anyone stands a 2.3 percent lifetime risk of developing glaucoma, first degree relatives (FDRs) of a glaucoma patient have a ten-fold increase in the risk of developing the condition. FDRs must therefore be more proactive about glaucoma. Facilitating investigations such as examination of the optic nerve can prevent complete blindness.
People who are over the age of 60 are at an increased risk of developing glaucoma. Further, medical conditions like diabetes, high blood pressure, thyroid disorders, long term use of steroids in all forms and heart disease are all conditions that put a person at risk of glaucoma. A regular eye check-up is a must for all open angle glaucoma patients, and they must get their eye check-up done more frequently, either as prescribed by the doctor or at least after every three months.
After the diagnosis of open-angle glaucoma or Kala motia, as called in Hindi, the treatment is focused on bringing down the eye pressure with the use of eye drops. Once glaucoma is diagnosed, an ophthalmologist prescribes the best-suited eye drops. Besides eye drops other medications may also be prescribed after considering the other medical conditions in the patient. If these treatments fail to show the desired results, options like laser, surgical procedures, and filtration devices are recommended. These treatments can significantly improve the quality of life of patients living with glaucoma.
A healthy lifestyle consisting of nutrient-rich foods, moderate exercise, is very important to maintain overall health. One must ensure that they get all essential vitamins and minerals which are primary source of carotenoids, that benefit over all vision health. Sleeping with the head raised to 20 degrees also helps in reducing intraocular pressure. Besides these, one must not miss the doses of the prescribed eye drops or oral medications and visit treating doctor regularly for eye examinations.
Due to lack of awareness, glaucoma remains largely undiagnosed, resulting in delayed medical intervention. There are also concerns about the absence of treatment compliance and follow-up consultations. Going forward, implementing effective and accessible approaches for screening, diagnosing, monitoring, and managing glaucoma is required to reduce the overall disease burden.
(The author os Senior Consultant, Glaucoma / Comprehensive Ophthalmology, Swarup Eye Centre, Medivision; Brij Netralaya: Eye Clinic)