Glaucoma: The Silent Thief of Sight

Glaucoma is a serious eye condition that can lead to irreversible blindness if left untreated. Renowned ophthalmologist Prof. Dr. Bashir Ahmad sheds light on this disease, emphasizing the importance of understanding its nature, types, symptoms, risk factors, prevention, treatment, and the necessity of regular check-ups, especially for individuals over 40. Glaucoma Week is observed worldwide in March to raise awareness about this sight-threatening condition.

What is Glaucoma?

Glaucoma is a group of eye diseases that damage the optic nerve, which is essential for transmitting visual information from the eye to the brain. This damage is often caused by elevated intraocular pressure (IOP), but it can also occur with normal or low IOP. As the optic nerve becomes damaged, peripheral/side vision is typically affected first, leading to gradual vision loss that can eventually result in blindness if not managed effectively.

Types of Glaucoma

Glaucoma can be from birth known as congenital glaucoma which fortunately is rare and acquired glaucoma which can occur at any stage of life.

The acquired glaucoma may be Primary Open-Angle Glaucoma (POAG) which is the most common type of glaucoma and often develops slowly over time without any noticeable symptoms until significant vision loss has occurred.

Angle-Closure Glaucoma: It is an emergency type of glaucoma and the patient goes in for immediate treatment. This type of glaucoma occurs when the iris blocks the drainage angle of the eye, leading to a sudden increase in intraocular pressure. Symptoms can include severe eye pain, headache, blurred vision and nausea requiring immediate medical attention.

Normal-Tension Glaucoma: In this type of glaucoma, optic nerve damage occurs despite normal intraocular pressure. The exact cause is not fully understood, but factors such as reduced blood flow to the optic nerve and increased sensitivity of the optic nerve to pressure changes may play a role.

Secondary Glaucoma: This type of glaucoma occurs as a result of another eye condition, such as untreated cataract, eye injury, uveitis and prolong use of certain medications locally or systematically.

Symptoms of Glaucoma

In the early stages, glaucoma typically does not cause noticeable symptoms. However, as the disease progresses, symptoms may include:

l  Mild dull boring type of headache

l  Mild to severe eye pain

l  Blurred vision

l  Halos while looking at source of light

l  Advance loss of peripheral and central vision

Risk Factors of Glaucoma

Several factors can increase the risk of developing glaucoma, including:

l  Age: The risk of glaucoma increases with age, particularly after the age of 40.

l  Family history: Having a family history of glaucoma increases the risk of developing the condition.

l  Race: People of African descent are at a higher risk of developing glaucoma and are more likely to experience severe vision loss from the disease.

l  Medical conditions: Certain medical conditions, such as diabetes, hypertension, and heart disease, can increase the risk of developing glaucoma.

l  Swollen eye lens can increase the risk of glaucoma.

l  Eye conditions: Certain eye conditions, such as high myopia (severe nearsightedness) and eye trauma, can increase the risk of glaucoma.

Prevention and Treatment of Glaucoma

While there is no known way to prevent glaucoma, early detection and treatment can help prevent vision loss. Treatment options include:

l  Prescription of eye drops to reduce intraocular pressure

l  Laser therapy to improve drainage of aqueous humor from the eye

l  Surgical procedures to create a new drainage channel or reduce the production of aqueous humor.

Regular eye examinations are essential, especially for individuals over 40, to detect glaucoma early and prevent vision loss.

Importance and Cautioning of Glaucoma

Glaucoma is often referred to as the “silent thief of sight” because it can cause vision loss without any noticeable symptoms until the disease has progressed significantly.

The disease has to be diagnosed and treated at an early stage. Once the disease has been diagnosed it needs treatment. Which may be in the form of drops, sometimes combine with systemic administration of drugs, laser treatments or surgery depending on the type or severity of the disease.

The treatment of glaucoma is life-long. The disease can be controlled but there is no known way to cure the disease. The damage done during the course of disease progress cannot be reversed. The medications are to be strictly adhered to as per the recommendation of the treating ophthalmologist.

In my long practice of treating this condition I have often seen that patients discontinue the treatment or reduce the frequency of the medication on their own which is very hazardous for the patients.

The equipment and technical knowhow of treating the disease is available within the state and there is no need for the patients to go outside the state for the treatment of glaucoma nor do we need any help from outside sources to treat this disease.

By raising awareness and promoting early detection, we can help preserve the sight of individuals and prevent the risk of developing this sight-threatening disease.

By Prof (Dr) Bashir Ahmad

Prof. Dr. Bashir Ahmad is a Director, Eye Care And Research Centre