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Beware of sneaky thief of sight

Today marks the first day of World Glaucoma Week, a disease that is the leading cause of irreversible blindness in the world. The disease has no early warning signs or painful symptoms

Betty Muindi @BettyMuindi

At least 50 people will be diagnosed with vision impairment or complete lose sight today due to glaucoma. Latest statistics from the Ministry of Health show that 25,000 of 200,000 people with the disorder are blind. Over 20,000 cases being reported every year.

Kenya is among the countries with high reported cases of the disease that afflicts over 70 million people worldwide, including seven million Africans. Despite how common glaucoma is, sadly many people do not know what it is, let alone know the signs of this silent but dangerous condition.

Glaucoma is an eye disease that causes progressive irreversible damage of the optic nerve. This nerve sends visual signals to the brain, where they are processed into what you “see”.

No one knows what causes glaucoma, but pressure build-up in the eye has been proven to be a major risk factor. When the pressure in the eye gets too high, the optic nerve can get damaged. This damage causes some signals from the eye not to reach the brain. The result is that you can’t ‘see’ everything your eye sees.

This leads to reduced visual field, and if not managed, may lead to blindness. “With the exception of babies born with congenital glaucoma, there is usually no warning, or obvious symptoms of the disease, which has led to glaucoma being described as the ‘sneak thief of sight’,” says Sheila Marco, Consultant Ophthalmologist and Glaucoma Specialist at Aga Khan University Hospital.

If statistics are anything to go by, over 50 percent of Nairobi residents could be having glaucoma, but are undetected because they do not go for regular examinations. Marco says many people know their status late when irreversible loss of vision has occurred.

To know if your baby is suffering from Glaucoma at birth, Marco tells parents to look out for bulging and swollen eyes. Approximately one in 10,000 babies have glaucoma and parents noticing symptoms should have a check carried out by an ophthalmologist.

“Early detection and appropriate therapy of glaucoma can significantly improve a child’s future life and vision. Treatment involves careful evaluation under general anaesthesia.

The intra ocular pressure (IOP) is measured and treatment by surgery can be carried out at the same time, which reduces subjecting the child to multiple sessions of general anaesthesia.” she says.

Although anybody is at risk of getting glaucoma, there are certain groups of people who are at a higher risk of contracting the disease. These include those with history of glaucoma in the family, adults over 35 years of age, African race, high IOP, myopia (shortsightedness) and diabetes mellitus.

If a member of a family has glaucoma, it is advisable for the other family members to see an ophthalmologist for eye check-ups. “The only way to detect and treat glaucoma early is by going for regular eye screening by an eye specialist particularly for the people at a higher risk.

The doctor measures the pressure of the eye and examines the optic nerve in the eye. If necessary a visual field test will be performed,” says the doctor. The main goal of treatment is to reduce the IOP to a safe level and prevent further loss of vision.

This can be done by using pressure lowering eye drops, lasers or a variety of surgical procedures. Once glaucoma is diagnosed and treatment started, the follow-up with an ophthalmologist is life-long.

Aga Khan University Hospital runs a glaucoma clinic every Wednesday and Thursday from 9.00 am to 5.00 pm by a glaucoma specialist. The Hospital has invested in the latest technology equipment for diagnosis and treatment of the disease.

One of the signs of glaucoma is worsening of the peripheral vision or the appearance of “blind spots”. This can be realised by a patient when they are not able to see stairs clearly as they walk down stairs, or bump into people as they are not able to see them.

In some cases, a driver fails to notice vehicles on either side of his or her car, which indicates an advanced case of glaucoma. As the optic nerve is an extension of the brain, treatment by surgery is currently not available, but extensive research is being carried out to develop new treatments for glaucoma.

Meanwhile, controlling IOP is the only way of slowing progressive blindness caused by glaucoma. The suffering caused by glaucoma highlights the importance of seeing an ophthalmologist in addition to regular eye screening for early detection of the condition and management.

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