In India, every eighth individual or nearly 40 million have either glaucoma or are at risk of developing the disease. On the occassion of World Glaucoma Awareness Week, doctors talk about controlling this incurable disease. Sangeeta Yadav tells you more

What is Glaucoma

It is a disease that damages the optic nerve due to the eye pressure which leads to irreversible blindness. Glaucoma is a silent disease as it doesn’t show any sign of pain and symptoms as it is all internal process. Only through tests one can figure out. Till the last moment, the patent doesn't realise. “In Glaucoma, your vision slowly starts decreasing from the periphery which is why you don’t realise that you have Glaucoma. Thus, it is called the Sneak Thief of Sight. The pressure in the eye when increases cause the damage internally. The vision that you lost in Glaucoma, you can’t get back unlike cataract surgery where you get the eye-sight improves,” Dr Hasanain Shikari, consultant, ophthalmology & retina services, Saifee Hospital, says.

Test

Annual eye check-up every year especially post 40 years of age is a must. “There are three main tests — Visual Field, Optical Coherence Tomography and Pachymetry which helps in detecting the pressure in eyes. Patients must undergo Visual Field test and the other two only when it is advisable by the doctor. These tests can cost around `2000- `5000,”

Dr Ravi D, medical director, Dr Agarwal’s Eye Hospital, says.

types

There are two main kinds of Glaucoma which affect the patient — Open Angle Glaucoma and Closed Angle Glaucoma. “Primary Open Angle Glaucoma is the most common type of Glaucoma that gets detected over 50 years of age. It is a chronic Glaucoma type and is genetic causes to it. Closed Angle Glaucoma can be acute as well as chronic that can occur suddenly to above 40 years of age. In this condition, the eye produces water inside but if it doesn't get an outlet or if there is no balance between the production and drainage of the water from the eye, the pressure increases. The other causes can be trauma, injury to eye, high blood pressure, etc,” Dr Aggarwal says.

Statpack

Glaucoma is said to be the third leading cause of blindness, accounting for 12.8% of the country’s blindness.
Currently in India, every 8th individual or nearly 40 million has either glaucoma or is at risk of developing the disease. 11.2 million Indians suffer from the disease with 1.1 million blind.
It is estimated that 4.5 million persons globally get blinded due to glaucoma and that this number will rise to 11.2 million by 2022.
Due to the silent progression of the disease — at least in its early stages — up to 50 per cent of affected persons in the developed countries are not even aware of having glaucoma.

Causes

Though there are many risk factors that can get you Glaucoma, hereditary is one of the most common. “If you have a family history of Glaucoma, it is a strong indicator that you should get an eye check-up done for glaucoma. Second, if you get an injury in your eye, or have a high minus number or increase number can be a cause of Glaucoma. Sometimes cataract at an advance stage can also cause Glaucoma. The only measurable aspect of Glaucoma is the eye pressure which we can keep under control. The other factors don’t get clinically assessed,” Dr Shikari explains.

Early detection

The primary target is to diagnose Glaucoma early and to keep the eye pressure under control so that you don't lose more vision. Those who drink alcohol, smoke cigarettes and intake tobacco must get the test done. If you have diabetes, blood pressure, or on a medication for anti-depressing, sleeping pills due to insomnia, the screening for glaucoma is mandatory.

“Glaucoma is not getting younger. It affects people above the age of 40. It is like diabetes, once you have it you can keep it under control but can't get rid of it. It is a condition that stays in your eye and you have to control the pressure by measuring the end-point in Glaucoma,” Dr Shikari tells you.

Treatment

In early stages, the treatment starts with the drops. There are various types of drops given by the doctor depending upon how severe the damage is and how high the eye pressure is. Patient has to use the drop three times a day to control the pressure. If the pressure doesn’t stay under control with the drops, then there are surgery including the laser treatment and implants are suggested to keep the pressure under control.

medical advancement

In the West, doctors use implants in controlling the pressure. The implants are put inside the channel of the eye to increase the outflow of the water from the eye. In majority, there are other medical molecule that helps in control of Glaucoma,” Dr Shikari tells you.

risk factor

Once the medication starts, one should continue it every day without fail. “The major problem in Glaucoma is the patient compliance with the medicine because the cost of medicine is relatively high. It is essential that once you start the treatment, you continue it till the end without missing out on a single day. I always advise my patients that you may forget to eat your food but you must not forget to use your drops. Otherwise, your eye pressure spike and can cause permanent damage. The medicine also cost somewhere `1,000 onwards,” Dr Shikari says.

Myths

Extra reading, too much of crying and surfing on Internet on phone or working long hours on the computer, doesn’t get you Glaucoma or aggravate it,” Dr P Ramgopal, additional director, opthalmology, Jaypee Hospital says.