The Q’s and A’s of Glaucoma

Glaucoma is a leading cause of irreversible blindness. In 2013, the number of people (aged 40-80 years) with glaucoma worldwide was estimated to be 64.3 million, and it is expected to increase to 76.0 million in 2020 and 111.8 million in 2040. It becomes imperative for us to increase awareness about the disease. In this article, we hope to provide valid answers to the various questions bothering on the disease.

Let’s Begin

What is Glaucoma?

Glaucoma is a group of diseases that cause the death of the optic nerve (the ‘wire’ that carries visual information from the eye to the brain) resulting in a specific pattern of blindness.

The pattern of Blindness usually begins with loss of peripheral vision

What causes Glaucoma?

For certain reasons, there is a build-up of pressures inside the eye (intraocular pressure) and this pressure presses hard on the internal structures of the eyes, including the optic nerve. When the pressures become unbearable for the optic nerves, they begin to decline in function and eventually die. The death of the optic nerve resulting from an increase in the intraocular pressure is what is called Glaucoma

What are the main types of glaucoma?

Pressure build-up in the eye happens when there is either too much production of the aqueous humour (the fluid inside the eye) or obstruction of the outflow of the fluid from the eye. Depending on what is responsible for the increase in intraocular pressure, glaucoma is divided into various types:

1. Primary Open Angle Glaucoma (POAG) – fluid is accumulating in the eye even when the channel of outflow of the aqueous of the eye is open
2. Primary Angle Closure Glaucoma (PACG) – fluid is accumulating in the eye because the channel of Outflow of Aqueous is closed. 
3. Congenital Glaucoma – A child is born with it or it developed as the child grew.
4. Secondary Glaucoma – the presence of a disease or an eye injury is causing the accumulation of the fluid
5. Normal tension Glaucoma – there is no accumulation of fluid, yet nerves are still dying

Who is at risk of developing Glaucoma?

Some people say reading too much, or using glasses early in life or putting prescribed eye drops in the eye could be the possible causes but these are all false. Although it is not clear why some people get glaucoma and others don’t, but some things are known to increase the chances of developing glaucoma.

• Genetics – Glaucoma runs in families, having a close family member already diagnosed puts the rest of the family members at risk (especially first degree relatives)
• Age – Older people are more at risk, even though it can also happen at any age
• Race – Studies say people of African descent (blacks) are more likely to develop glaucoma than Caucasians (whites)
• Myopia – High myopes are at greater risk of having glaucoma
• Diseases – People with diabetes, high blood pressures and cardiac diseases are at higher risk

What are the Symptoms of Glaucoma?

Glaucoma is called the silent thief of sight because it shows no symptoms, especially the POAG. It causes no pain, no obvious change in vision (especially central vision), yet internal damages progress, only a comprehensive eye examination can reveal it.

For the other types (especially the PACG), there could be severe pain inside the eye, blurry vision, redness of the eyes, and sometimes, seeing rainbow around lights.

How is glaucoma diagnosed? 

Only a comprehensive eye examination from your Optometrist or Ophthalmologist will confirm a glaucoma diagnosis. The eye doctor will make a firm conclusion from assessing the internal eye, the pressures, the visual fields, corneal thickness and nerve fibre layer assessment.

How is glaucoma treated?

Glaucoma does not have a cure; it is managed over a lifetime. Any vision lost before a diagnosis cannot be restored medically. The key to effective management is consistency in follow-up and use of medication. Your doctor will be in a better position to advise on the best treatment modality.

Management Options include:

• Using eye drops/tablets; that lower intraocular pressures. It should be used every day of a lifetime
• Glaucoma Surgeries; where medications are not effectively controlling pressures alone
• Laser therapies; to provide effective non-invasive control of pressures
• Regular intake of eye antioxidants have proven to be beneficial

Some wrong myths about Glaucoma

1. If you have good vision and no symptoms, you won’t develop glaucoma – Glaucoma is a “silent thief of sight” because people will not notice symptoms until the glaucoma is moderate or advanced. Going for glaucoma screening is the wise thing to do.
2. Glaucoma is inherited, and since no one in my family has glaucoma, I won’t get the disease – although a family history of Glaucoma is a risk factor, there are many glaucoma patients who are the only ones in their families who are diagnosed with the disease.
3. Surgery Can Cure Glaucoma – There is no way to cure glaucoma. Surgical procedures can effectively treat symptoms of the disease, lower intraocular pressure and can stop vision loss from getting worse.
4. Developing glaucoma will cause you to go blind – The majority of individuals who develop glaucoma do not go blind during their lifetime. This is because glaucoma on average progresses very slowly, and early detection is key to benefiting from the management options.
5. Glaucoma only affects the elderly – it is true, age is a risk factor, yet it can affect any age group, even babies can have glaucoma.

In conclusion, a diagnosis of glaucoma is not a death sentence. With proper counselling, education and proper use of medication, vision can remain as it was when first diagnosed.
Have a comprehensive eye exam today for you and all members of your family.

Cheers to your eye health!!!

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