Glaucoma: The silent thief of sight

Glaucoma is a condition that causes damage to the eye’s optic nerve and gets worse over time.

OTHER than cataract, glaucoma is one of the leading causes of blindness worldwide.

It can damage your vision gradually, so you may not notice any loss of vision until the disease is at an advanced stage.

The most common type of glaucoma, open-angle glaucoma, has no noticeable signs or symptoms except for gradual vision loss.

There are several types of glaucoma. These include:

·Open-angle glaucoma: In cases of chronic glaucoma, there are usually no noticeable symptoms because it develops very slowly.

The first sign of trouble usually involves the outer field of vision (peripheral vision), and this slowly works its way inwards to affect central vision. Changes in vision are often linked to getting older, which is why it is important to have your eyes checked regularly. You should have an eye test at least annually.

·Acute angle-closure glaucoma: Acute angle-closure glaucoma develops rapidly. Symptoms are often severe, and may include intense pain and redness of the eye, headache, seeing halos or “rainbow-like” rings around lights, misty vision, and loss of vision in one or both eyes that progresses very quickly.

As a result of these symptoms, some people may also feel unwell. This can last for one or two hours, disappear, and occur again. But each time the symptoms occur, your vision is damaged a little more.

·Secondary glaucoma: This is caused by other conditions or eye injuries, such as uveitis (inflammation of the middle layer of the eye). It is possible for the symptoms to be confused with the symptoms of other conditions like painful eyes and headaches.

·Developmental glaucoma: Recognising the symptoms of developmental glaucoma (also known as congenital glaucoma) can be difficult due to the young age of the baby or child. However, your child may display symptoms such as large eyes, being sensitive to light (photophobia), cloudy appearance of eyes, watery eyes, jerky movements of the eyes, and squinting eyes.

In chronic open-angle glaucoma, the drainage channels are partially blocked, causing the fluid to drain out of the eye too slowly. This causes fluid to back up in your eye, and pressure gradually increases within the eye.

Damage to the optic nerve doesn’t cause symptoms or pain, and it happens so slowly that you may lose an extensive amount of vision before you’re even aware of the problem. The exact cause of chronic open-angle glaucoma remains unknown.

Angle-closure glaucoma, also called closed-angle glaucoma, occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and the iris.

As a result, fluid can’t adequately flow through and exit your eye, and your eye pressure may increase abruptly. Angle-closure glaucoma usually occurs suddenly (acute angle-closure glaucoma), but it can also occur gradually (chronic angle-closure glaucoma).

In normal-tension glaucoma, the optic nerve becomes damaged despite the eye pressure remaining within the normal range. Doctors don’t understand why this occurs. You may have a sensitive optic nerve, or you may have less blood being supplied to your optic nerve.

This lack of blood supply could be caused by atherosclerosis – an accumulation of fatty deposits (plaques) in the arteries – or other conditions that result in reduced blood circulation.

Glaucoma in children can be caused by angle blockages or malformation, or it could develop as the result of other conditions (secondary glaucoma).

Because chronic forms of glaucoma can destroy vision before any signs or symptoms are apparent, be aware of factors such as elevated internal eye pressure, being over 40 years of age, ethnic background, family history of glaucoma, medical conditions like diabetes, heart diseases, high blood pressure and hypothyroidism, other eye conditions like severe eye injuries, eye tumours, retinal detachment, eye inflammation and lens dislocation, as well as long-term steroid eyedrop use.

If left untreated, glaucoma will cause progressive vision loss, normally in these stages – first, blind spots in your peripheral vision, tunnel vision, then total blindness.

When do you see a doctor?

Don’t wait for noticeable eye problems to occur. Open-angle glaucoma gives few warning signs until permanent damage has already occurred.

Regular eye exams are the key to detecting glaucoma early to successfully treat the condition and prevent further progression.

It is recommended for all adults aged 40 to have a comprehensive eye check, and every three to five years after that, if you don’t have any glaucoma risk factors.

If you have other risk factors or you’re older than 60 years, you should be screened every one to two years.

Be aware that a severe headache or pain in your eye, nausea, blurred vision, or halos around lights may be symptoms of an acute angle-closure glaucoma attack.

If you experience some or several of these symptoms together, seek immediate care at an emergency room or at an ophthalmologist’s clinic immediately.

The goal of glaucoma treatment is to lower pressure in your eye (intraocular pressure). To treat the condition, doctors may improve drainage of fluid in your eye or lower the amount of fluid produced in your eye by using eyedrops, oral medications or surgery.

Glaucoma cannot be cured, and damage caused by the disease cannot be reversed, but treatment and regular check-ups can prevent vision loss in people with early glaucoma.

If vision loss has already occurred, treatment can slow or prevent further vision loss.

Some types of alternative medicine may help your overall health, but these won’t treat or prevent glaucoma.

Don’t depend on herbal remedies for the primary care of glaucoma. A number of herbal supplements, such as bilberry, are advertised as glaucoma remedies, but have not been proven effective in preventing or treating glaucoma.

Herbal supplements should never be used in place of proven therapies, and you should always discuss with your doctor before trying them.

Stress may trigger an attack of acute angle-closure glaucoma. If you are at risk of this condition, find healthy ways to cope with stress, like meditation.

Because there is no cure for glaucoma, a diagnosis generally means lifelong treatment and regular check-ups. Meeting and talking to other people with glaucoma can be very helpful. Check with hospitals and eye care centres in your area to find local groups

Preventive steps

·Eye examinations: As a general rule, have comprehensive eye examinations every three to five years after age 40, and every year after age 60. You may need more frequent screening if you have glaucoma risk factors.

Ask your doctor to recommend the right screening schedule for you.

·Treat elevated eye pressure: Glaucoma eyedrops can significantly reduce the risk of progression to glaucoma. To be effective, these drops must be taken regularly even if you have no symptoms.

·Eat a healthy diet: While eating a healthy diet won’t prevent glaucoma, it can improve your physical and mental health. It can also help you maintain a healthy weight and control your blood pressure.

·Wear eye protection: Serious eye injuries can lead to glaucoma. Wear eye protection when you use power tools or play high-speed racket sports on enclosed courts. Also wear hats and sunglasses if you spend time outside.

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