Glaucoma – The silent thief of eye sight

Dr Sabitha Safar, Consultant Ophthalmologist, SUT Hospital, Pattom

What is Glaucoma?

Glaucoma is a group of eye diseases that cause damage to the optic nerve, which is the nerve that carries visual information from the eye to the brain. This damage is usually the result of increased pressure within the eye, which can be caused by a build up of fluid that flows through the eye. It can cause irreversible vision loss and blindness if left untreated.

In India, the burden of glaucoma is 11.9 million, and the prevalence of blindness is 8.9 million. Glaucoma contributes to 12.8% of blindness in India. Epidemiological studies on glaucoma involving adults aged 40 years and above have estimated glaucoma prevalence between 2.7 and 4.3% among Indians.

Who is at Risk of Glaucoma?

• Age usually >40years
• Certain medical conditions, including hypertension and diabetes
• Extreme myopia or hyperopia
• Family history
• Genetics
• High intraocular pressure
• Long-term corticosteroid use
• Previous eye injury or surgery
• Thinner corneas

Types of Glaucoma

There are many types of glaucoma. Each type of glaucoma develops differently, but all of them place your vision at risk.

1. Open-Angle Glaucoma
2. Angle-Closure Glaucoma
3. Normal-Tension Glaucoma
4. Secondary Glaucoma

Some types of secondary glaucoma include:

• Exfoliative glaucoma
• Neovascular glaucoma
• Pigmentary glaucoma
• Traumatic glaucoma
5. Congenital Glaucoma

Congenital Glaucoma, childhood glaucoma, infantile glaucoma or pediatric glaucoma is found to occur in babies and infants (< 3 years of age). It is a rare condition but could result in a permanent loss of vision.

Symptoms and signs of childhood glaucoma include:

• The Triad of: watering/ epiphora, photophobia and blepharospasm
• Enlargement of the eyes (Buphthalmos)
• Hazy cornea
• Redness of the eye

Causes

• Build-up of aqueous humor inside the eye
• Genetic reasons
• Birth defects in ocular angle
• Underdeveloped cells, tissues

Prevention of Congenital Glaucoma

It cannot be fully prevented but complete vision loss could be prevented when diagnosed early. The best ways to ensure we catch congenital glaucoma early are:

• To have eye checkups often
• To be aware of your family’s medical history

Diagnosis

a. Medical history
b. Comprehensive eye examination, including:

• Tonometry.
• Imaging tests.
• Visual field test.
• Measuring corneal thickness (pachymetry)
• Inspecting the drainage angle (gonioscopy)

Treatment for glaucoma

The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.

Glaucoma is treated by lowering intraocular pressure. Treatment options include prescription eye drops, oral medicines, laser treatment, surgery or a combination of approaches.

The goal of treatment is to reduce the pressure within the eye and prevent further damage to the optic nerve.

World Glaucoma Day 2024

World Glaucoma Day is celebrated on March 12th every year to raise awareness about glaucoma. It is an important day that highlights the need for regular eye exams, early detection, and treatment of glaucoma. This year’s theme “Uniting for a Glaucoma-Free World” focuses on bringing communities worldwide to fight together against glaucoma blindness.