Known as the silent blinding disease, approximately 70 million individuals worldwide are affected by glaucoma, a frightening statistic when remembering that the South African population consists of just over 60 million people, according to the latest census.
Therefore, it is vital to understand more about glaucoma and how it comprises a group of eye diseases leading to progressive damage of the optic nerve.
Since the optic nerve is vital for transmitting information from the eye to the brain, glaucoma can cause gradual, irreversible vision loss and eventual blindness.
Considering the impact glaucoma has on people’s lives, Mediclinic Newcastle is actively participating in raising awareness during World Glaucoma Week, observed from 10 March 2024 to 16 March 2024, with renowned Ophthalmologists/Eye specialists, Dr Asgar Ali Sahib and Dr Junaid Zondi.
Dr Sahib elucidated the pivotal role of the optic nerve in sight, emphasising its role in capturing images through the retina and transmitting them to the brain.
“So, your optic nerve, when you are born, has about a million axions, and throughout life, you lose those axions. You lose them from injuries, infections, etc. But glaucoma now comes along and the pressure in the eye builds up. Now, like a car tyre requires pressure of two bars, the eye has a pressure range that it should be within.”
This pressure is linked to Aqueous fluid that circulates in the eye, and as per Dr Sahib, if a person’s eye drains less fluid than it is producing, your eye will build up pressure.
“So, you have to have a balance between the amount of fluid within the eye,” elaborated Dr Sahib, who pointed out that this aqueous fluid is often confused with tears.
According to Dr Sahib, this aqueous fluid plays an essential role in maintaining a balance within the eye, where the optimal range needs to stay between 10 and 20 mmHg (millimetre of mercury). Furthermore, he stated that if this pressure goes up too much, the optic nerve bears the brunt of it and becomes cupped. This in turn starts impacting your vision, starting with your peripheral vision, before escalating to the point where a person loses total sight.
Making this process even more terrifying, a person does not experience any symptoms during this time. “We call it the silent thief of sight, as while you are losing vision, you experience no pain. You feel nothing,” explained Dr Sahib.
Concurring with the above, Dr Zondi defines glaucoma as a progressive optic retinopathy associated with high intra-ocular pressure, resulting in irreversible optic nerve damage, whereby, he outlined four glaucoma types:
- Congenital glaucoma – This occurs in childhood.
- Open-angle glaucoma – Painless and slowly progressive, and the most common form of glaucoma.
- Closed-angle glaucoma – Painful and acute.
- Secondary glaucoma – This is caused by external factors such as trauma.
Agreeing with Dr Sahib in that there were no signs and symptoms, he noted that one should look out for decreased vision and a reduced visual field. Another symptom, he highlighted was eye pain, which was present in closed-angle glaucoma. “This is why regular eye exams are important,” stated Dr Zondi.
When looking at people who were most at risk, Dr Sahib noted the African/Black population was at the highest risk, followed by Caucasians. He further explained that other people at high risk were shortsighted people and diabetics. Additionally, Dr Zondi highlighted other factors including advanced age and a family history of glaucoma.
Regarding family history, Dr Sahib said if people were aware of glaucoma in their family, it was important to undergo screening, especially from the age of 40.
He noted this was where optometrists played an important role in screening and checking a person’s eye pressure. He added that eye specialists also scanned people’s visual field and optic nerves to establish if a person had glaucoma.
While many focused on glaucoma in adults, when it came to childhood glaucoma, Dr Zondi highlighted that this issue accounted for approximately 25% of glaucoma cases. He explained that when a child is born with glaucoma, it is believed that the pressure was raised in intra-uterine life itself. This resulted in a birth defect in the development of the eye, due to poor development, leading to an abnormal flow of fluid and subsequent increase in pressure within the eye.
With this in mind, Dr Zonndi suggested parents should look out for the following symptoms in their children:
- Photophobia – This is when a child is bothered by light.
- Watery eyes
- Blepharospasm – This is when a child tends to keep their eyes closed.
- Increase in eye size due to pressure.
- An opaque appearance of the eye.
Looking at the negative implications that glaucoma had on a person’s sight when untreated, Dr Zondi stated that there were both medical treatments and procedures available.
These treatments included oral medications, topical eyedrops, laser treatment for those not fully responsive to the medication, and drainage surgery where devices are placed in the eye to assist drainage of Aqueous fluid.
Concluding, Dr Sahib noted that the eye drops were extremely effective in assisting with 90% of cases. He stressed medical aids recognised glaucoma as a chronic condition and covered the expense of the costs of the drops.
When considering the above mentioned, be sure to visit your optometrist or local Ophthalmologist/Eye specialist to ensure you catch glaucoma in time, and don’t lose your sight to a preventable condition.
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