Glaucoma: The silent thief of sight

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by Akinlabi bisola

March 10-16 is the World Glaucoma Week, which is a joint initiative between the World Glaucoma Association and the World Glaucoma Patient Association and has had a highly successful run for the past 10 years. This year’s theme is ‘ B-I-G’
Beat Invisible Glaucoma. Glaucoma is a public health problem, it is the second leading cause of blindness. Population studies in Nigeria revealed that 1.8 million people over 40 years suffer from glaucoma with almost 20% of them blind in both eyes. Everybody is at the risk of glaucoma but higher in the population over 30 years.
OVERVIEW
Glaucoma is the name given to a group of eye conditions in which the optic nerve is damaged, this nerve carries information to the brain from the light sensitive layer in the eye which is the retina and this information is perceived as picture. In healthy eye, a clear liquid circulates in the front portion of the eye. To maintain a constant healthy eye pressure, the eye continually produces a small amount of this fluid and an equal amount which flows out of the eye. If you have glaucoma, the fluid does not flow properly through the drainage system, fluid pressure in the eye increases and this extra force presses on the optic nerve in the back of the eye, causing damage to the nerve fibres. Glaucoma is an extremely serious eye disorder which can cause blindness if not treated early.
Glaucoma comes in different forms, but the most common form is the Open-angle glaucoma, vision loss may result. This form of glaucoma develops slowly and usually without any symptoms, many people are not aware they have the condition until they have significant vision loss. Initially, glaucoma affects side or peripheral vision but it later advance to central vision loss. A less common type of glaucoma, acute angle-closure glaucoma which usually occur abruptly due to a rapid increase of pressure in the eye. It’s symptoms may include severe eye pain, nausea, redness in the eye, seeing halo’s or coloured rings around lights and blurred vision. This is an emergency condition which severe vision loss occur quickly.

Symptoms
In the early stages of glaucoma, there are frequently no obvious symptoms and whilst increased pressure in the eye may be an indicator, this will not necessarily mean you have the disease. The most efficient detection method for glaucoma is by regular eye examination.

Risk factors
These are factors that make an individual predisposed to certain diseases and for glaucoma, they include the following;
*Age (40 and above).
*Family history of glaucoma.
*Race ( more common among blacks).
* Some medical conditions such as diabetes, high blood pressure and some heart diseases.
* Physical injury to the eye.
This factors are further compounded by poor awareness and low knowledge about glaucoma even by the persons affect.

Causes
There are many theories about the causes of glaucoma, but the exact cause is unknown. Although the disease is usually associated with an increase in the fluid pressure inside the eye, other theories include lack of adequate blood supply to the nerve. The type of glaucoma will determine it’s potential cause,
1. Primary open-angle glaucoma: one theory about its development is that the eye’s drainage system becomes insufficient over time. This leads to an increased amount of fluid and a gradual build up of pressure within the eye. Another theory about the cause of this type of glaucoma is that there is poor flow of blood to the optic nerve.
2. Angle- closure glaucoma: this form develops when the drainage angle in the eye closes or become blocked. Many people who develop this type of glaucoma have a very narrow drainage angle. With age, the lens in the eye becomes larger, pushing the iris forward and narrowing the space between the iris and the cornea. As this angle narrows, the fluid in the eye is blocked from the drainage system. Therefore the fluid builds up and eye pressure increases.
3. Secondary glaucoma: this type of glaucoma occurs as a result of injury to the eye or other eye diseases. It may be caused by variety of medical conditions, medication’s, physical injuries and eye abnormalities.
4. Normal-tension or low-tension glaucoma: in this type of glaucoma, eye pressure remains within the normal range, but the optic nerve is damaged nevertheless. It is not known yet why this happens possibly, people with low-tension glaucoma have abnormally sensitive optic nerve, or they may have a reduced blood supply to the optic nerve caused by heart conditions such as atherosclerosis.

Treatment
Glaucoma cannot currently be prevented but if diagnosed and treated early, it can be controlled. Medication or surgery can slow or prevent further vision loss. However, vision already lost to glaucoma cannot be restored.

Diagnosis
Glaucoma is diagnosed through a comprehensive eye examination.

Glaucoma week started on Monday 10th of March and it’s ending Friday 16th of March and to commemorate the week government hospitals are organising free eye test for glaucoma, so please let’s endeavour to make use if this opportunity as glaucoma does not give symptoms until almost half of the sight us gone. Early detection and prompt treatment is the key to its management to stop further eye damage.
Don’t sleep on it, go for your test now.

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