Glaucoma- the silent thief of sight


By Dr. Sachindra LaishramGlaucoma is a generic name for a group of diseases causing optic neuropathy and visual field loss, usually, but not always, in the presence of raised IOP. Glaucoma is one of the important causes of irreversible partial or total loss of vision.
Glaucoma accounts for 1.7% of economic blindness in India according to WHO-NPCB-I986-89. It affects around 1-2% of general population older than 40 and accounts for nearly 20% of the blindness in the world. It is estimated that more than 2.2 million people over the age of 40 have glaucoma.
In the 10th century, Al-Tabari was the first to suggest association of glaucoma with raised intraocular pressure. Mackenzie finally established this in 1835. Since then it has widely been accepted that glaucoma is essentially a disease caused by intraocular pressure.
Glaucoma can cause permanent damage to your vision before you even suspect that something is wrong. That is why glaucoma is called “silent robber of sight”. Glaucoma doesn’t mean the end of your productive life. Advances in therapy have enabled people to maintain their normal lives, regardless of the disease. With an early diagnosis and early initiation of therapy, most people with glaucoma do not go blind.
Types of GlaucomaThere are several types of glaucoma. Because their causes and the people they affect are so diverse, they may require different forms of treatment.
Open angle glaucomaClosed angle glaucomaNormal tension glaucomaSecondary glaucomaCongenital glaucomaMixed mechanism glaucomaRisk Factors for glaucomaCertain conditions put some people at more risk for glaucoma.• Age more than 45• Family history of glaucoma• Mongoliod descent• Diabetes• Myopia• Regular long term use of steroid• Previous eye injuryWhy is early detection important?According to the glaucoma foundation, for people aged 45 years and above, exams should be scheduled every 2 years if you have no risk for glaucoma, and every year if you have risk factors for glaucoma.
As the damage done by glaucoma are permanent, early detection and initiation of treatment is of prime importance. As the patients are not aware of the symptoms in the early stage, routine and regular check-up is very important. The doctor will measure the IOP, assess the optic disc and go for Visual field assessment in specific cases. They will be able to pick up the cases of glaucoma at a very early stage with the modern technology available.
Treatment optionsEye drops, pills, Laser surgery, eye operations or a combination of these approaches may be used to treat glaucoma. Typically, they all work to help in keeping IOP under control.Take home message• In its early stages, glaucoma has no symptoms and damage caused by glaucoma is irreversible.• It is important that you continue to take your drops every day to avoid losing your sight permanently.• Keep your regular visits to the clinic/hospital without fail.• Please comply with the doctor’s advice and treatment.• Never change or stop taking your medications without consulting your doctor.• Whenever you see any other doctor, make sure he knows you have glaucoma.• Your vision is more precious than the cost of medication.• If you have a history of glaucoma in your family, please get your relatives examined for the same, as glaucoma is hereditary.• If you have any problem with your medication, talk to your doctor as soon as possible.This article is written for general awareness by:Dr. Sachindra LaishramM.D. (Ophthalmology)Consultant OphthalmologistShija Eye Care Foundation, Langol, Imphal


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