Article by Dr.R.Adamson,Ghana
Every year, during the second full week of March, we observe World Glaucoma Week, an initiative spearheaded by the World Glaucoma Association. The goal of this week is to raise awareness about glaucoma, emphasize the need for early detection, and advocate for the various management options available for the disease.
This year’s theme is “Uniting for a Glaucoma-Free World.”
What is Glaucoma?
Glaucoma refers to a group of diseases characterized by optic nerve degeneration and retinal ganglion cell loss. These conditions lead to a reduction in vision, especially in peripheral fields. The optic nerve, made up of many smaller nerves, sends messages from the eye to the brain, similar to how an image is transmitted from a camera to a screen. However, glaucoma damages these nerves, affecting sight.
Why is Glaucoma a Silent Threat?
The damage caused by glaucoma is not noticeable until approximately 50%-70% of an individual’s optic nerve fibers have been irreversibly damaged, making it a “silent enemy.” According to the World Glaucoma Association, glaucoma is the leading cause of irreversible, preventable blindness. In 2020, about 76 million people were affected by glaucoma, and this number is expected to rise to 95.4 million by 2030. Around 7.7 million people suffer from moderate to severe vision impairment or blindness due to glaucoma.
The numbers highlight the devastating impact of glaucoma on quality of life, which underscores the need for greater awareness, early detection, and prevention of blindness.
The Silent Symptoms of Glaucoma
Glaucoma often shows no symptoms in its early stages. By the time an individual begins to notice symptoms—such as visual impairments—the disease is typically in an advanced stage, with significant damage to the optic nerve (around 40% of nerve fibers irreversibly damaged).
Risk Factors
Several factors increase the risk of developing glaucoma:
- Elevated intraocular pressure (the only modifiable risk factor)
- Age: Glaucoma is more common in older adults but can affect people at any age
- Race: People of African descent or Hispanic ethnicity are at higher risk. Glaucoma is more likely to be diagnosed in Black individuals than in whites
- Family history: Having a first-degree relative with glaucoma increases the risk
- Myopia (nearsightedness) and thin central cornea are also linked to higher risk
- Other systemic factors: Diabetes, hypertension, and low ocular perfusion pressure
Emerging studies suggest that conditions such as sleep apnea, thyroid disorders, high blood cholesterol levels, migraine headaches, low cerebrospinal fluid pressure, and Raynaud phenomenon may also increase glaucoma risk.
Impact on Daily Life
In advanced stages, glaucoma can affect daily activities, including:
- Difficulty seeing in low light
- Faded vision when reading
- Trouble seeing objects at the periphery (side vision)
- Blurred vision and missing areas of sight
This vision loss can significantly impact driving, walking, reading, color perception, and nighttime vision. It can also lead to accidents, falls, and even motor vehicle collisions. Beyond physical challenges, these changes often lead to mental health struggles as individuals adapt to the limitations on their daily activities and independence.
Prevention and Treatment
Although glaucoma is not curable, it is treatable, and early detection is key. Anyone over the age of 30 should have their eyes checked regularly by an ophthalmologist, particularly those with a family history of glaucoma or who are at higher risk.
The goal of treatment is to preserve the remaining nerve fibers by controlling intraocular pressure (the only modifiable risk factor). Treatment options include:
- Medications: Eye drops and oral medications to reduce intraocular pressure
- Laser treatment and surgery for more advanced cases
Treatment for glaucoma is a long-term commitment, much like managing other chronic conditions (e.g., diabetes or hypertension). Medications should be used consistently, even if there is no noticeable improvement in vision or symptoms.
If you experience discomfort or side effects from glaucoma medications, consult your ophthalmologist for further assessment and management.
Be Cautious with Steroid Use
It is important to avoid abusing steroids, especially when used as eye drops, as they can trigger glaucoma. Always follow your doctor’s recommendations regarding medications.
Get Tested Today!
Remember, glaucoma is a silent thief of sight. Its impact on individuals and society is profound. To prevent irreversible vision loss, it’s crucial to get tested, especially if you:
- Are 30 years or older
- Have a family history of glaucoma
- Are of African or Hispanic descent
- Have a refractive error (e.g., nearsightedness)
- Are on medications that could cause glaucoma
Early detection can help protect your vision and reduce the long-term socio-economic impact of vision loss.
Resources:
- Ahmad Syed, Taiwan J Ophthalmol, Volume 8, Issue 2, April-June 2018
- World Glaucoma Association
- American Academy of Ophthalmology, Basic and Clinical Science Course, Section 10, 2022-2023