Glaucoma is the leading cause of irreversible blindness around the world and, as per the National Programme for Control of Blindness, the third leading cause of blindness in India. Glaucoma, popularly known as ‘kaala motiya’ is asymptomatic in its early stages and leads insidiously to an irreversible visual impairment. However, early detection can halt the progress of the condition and prevent loss of vision.
WHAT IS GLAUCOMA?
Glaucoma refers to a condition of the eye where an increased pressure (unrelated to blood pressure) leads to the damage of the optic nerve. This damage is irreversible and once lost, vision cannot be restored by medication or surgery.
The real challenge in the diagnosis of this disease is its symptomatology and its slow progression. It is usually asymptomatic in the early stages, although a patient may complain of increased problems with near vision, occasional headache and loss of peripheral vision. In India, where the majority of visual complaints is still managed by the shorter route of getting a fancy new pair of glasses from the nearest optical shop, a thorough eye examination is often missed. The diagnosis of glaucoma, a condition which is usually picked up by an ophthalmologist in a routine eye examination, gets delayed. Asymptomatic glaucoma is thus allowed to follow its relentless course towards severe visual loss before medical attention is sought. A patient may even ignore glaucoma-induced blindness in one eye as long as the other eye remains functional, not realising that the same fate is slowly unfolding for the better eye.
DO I HAVE AN INCREASED RISK OF DEVELOPING GLAUCOMA?
There are various known risk factors for the development of glaucoma, with age being one of them. People over 40 years are at a relatively higher risk of developing glaucoma. With a strong genetic linkage, a positive family history also increases the risk of developing glaucoma by up to ten times. So, if someone has glaucoma, they must get blood relatives tested as well.
Apart from age and genetics, myopia, migraine, diabetes, hypertension, thyroid and trauma to the eye also increase the risk of developing glaucoma.
WHAT SHOULD I DO AFTER THE DOCTOR TELLS ME I HAVE GLAUCOMA?
Remember that damage caused by glaucoma is permanent and irreversible. Once glaucoma is detected, the treating ophthalmologist performs certain tests to quantify the visual impairment and find the subtype of glaucoma. Subsequently, patients are advised medication, laser therapy, surgery in advanced cases, or a combination of these. The treatment given aims to halt the progression of the disease by bringing down the eye pressure, but it cannot reverse the visual loss which has already occurred.
Treating glaucoma successfully requires the team effort of the treating doctor and the patient. It is imperative that the patient does not discontinue medication without consulting the doctor. Compliance with the prescribed medication is extremely important as any spike in eye pressure can have deleterious effects on a glaucomatous eye.
The diagnosis of glaucoma is often shocking for the patient who perhaps went prepared only for being prescribed new glasses. The possibility of having a chronic, potentially blinding disease is difficult for the patient to accept, hence communicating clearly for better understanding and laying out a clear plan of action are important. Even when glaucoma has already delivered a harsh lesson, careful education is still needed to help the patient understand the nature of the disease, the rationale for treatment and the importance of compliance.
For a patient affected by glaucoma, the impact can be profound, which can include difficulty with mobility, driving, employment and depression. A high level of awareness and knowledge of this silent killer of the eye is the need of the hour. For public awareness and patient education, there are various portals and websites by numerous ophthalmological societies across India. A timely diagnosis, initiation of treatment and compliance with treatment lifelong can conquer this potentially blinding disease.
So, the next time you have any symptoms related to your eyes, book an appointment with an ophthalmologist without delay and kick this devil out before it knocks you out.
The writer is Consultant Ophthalmologist, NKS Hospital, Delhi.
