Glaucoma: early detection is the way to go

Dear doc,

What is glaucoma and is it true that it can cause blindness?

Miriam.

Dear Miriam,

Glaucoma is a universal term that refers to a range of eye conditions that cause damage to the optic nerve.

There are many types of glaucoma, although all of them occur as a result of increased pressure in the eye. The most common ones are open-angle glaucoma and angle-closure glaucoma. In open-angle glaucoma, there is a blockage in the channels responsible for draining fluid within the eye, which leads to gradual loss of vision. One eye is usually more affected than the other.

This kind of glaucoma normally has few or no noticeable symptoms, such that most people might not recognise for a long time that they are losing their vision. Open-angle glaucoma is the more widespread form, and it generally appears in middle age.

In angle-closure glaucoma, pressure builds up in the eye just as it does in open-angle glaucoma, but it begins much more abruptly. It is less common but when it occurs, it calls for emergency treatment. It is characterised by blurred vision, pain in the eye and headaches.

Other forms of glaucoma include congenital glaucoma, where one is born with the condition. Secondary glaucoma is related to another eye disorder or disease, for instance eye injury, bleeding, eye tumor, uveitis (inflammation of the uvea, the middle part of the eye) or a very mature cataract.

Glaucoma causes damage to the optic nerve (part of the eye that transmits visual information from the retina to the brain) as a result of increased pressure in the eye. The damage caused to the eye is irreversible, which means glaucoma can cause permanent loss of vision.

Dear doc,

Can glaucoma be inherited and what are some of the risk factors that increase chances of getting the disease?

Jerry.

Dear Jerry,

If there is a history of glaucoma in your family, there is a higher risk that you will have it. Glaucoma might have a genetic link, which means there is a defect either in one or more genes that make particular people more susceptible to glaucoma.

Certain medical conditions such as heart diseases, diabetes, hypothyroidism, and high blood pressure can increase your chances of getting glaucoma.

Other eye conditions such as serious injuries can result in increased pressure in the eye, thus causing glaucoma. Other eye conditions that can increase your risk of developing glaucoma include retinal detachment (retina detaches from its normal position), eye traumas, dislocation of the lens and inflammation of the eye. There are some types of surgery that can trigger glaucoma.

Being farsightedness or near sightedness can also put you at risk of having glaucoma.

Use of corticosteroid medications such as eye drops for a long time can increase the risk of developing secondary glaucoma.

Age is also a contributory when it comes to the onset of glaucoma. People of 35 and above are more likely to develop glaucoma than those who are younger.

Dear doc,

How is glaucoma treated?

Jackie

Dear Jackie,

The main goal of treating glaucoma is to avoid further damage to the eye and maintain the highest possible level of sight. Glaucoma treatment aims at making intraocular pressure normal, thus retarding or preventing further damage to the nerve and visual loss.

In some cases, eye drops are used as the first option, but in other cases, surgery or laser treatment is preferred. The patient might need to try more than one type of eye drop or use the medication a number of times in a day in order to lower the intraocular pressure.

Eye drops work by either increasing the drainage of fluid from the eye or through decreasing the production of aqueous fluid. Some of the side effects of eye drops are fatigue, a slow heart rate and low blood pressure.

Dear Doc,

How often should a person be screened for glaucoma?

Anonymous.

Dear anonymous,

Any person who is 35 and above, or has a history of glaucoma in the family, should go to an ophthalmologist for an eye examination at least once every year or every two years. This helps identify the disease before it progresses. Eye screening is not just for detecting glaucoma, but other conditions such as cataracts.

Dear doc,

Can glaucoma be prevented?

Kim.

Dear Kim,

Unfortunately, glaucoma cannot be prevented, but its progress and loss of sight can be slowed if it is detected early and treatment sought before the fibers of the optic nerve are destroyed.

Therefore, those at risk, especially those whose close family members have glaucoma, should have their eyes examined regularly, especially if they are above 35.

Further, they should not ignore any symptom of eye problems. When detected early, glaucoma can often be controlled with medication, either in the form of pills or eye drops. If medications do not work your doctor might recommend a surgery.

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