Glaucoma, the 'silent thief of sight': Diagnosis, ways to tackle vision loss
Glaucoma is referred to as "silent thief of sight" as symptoms usually do not appear until the disease has progressed. Here are its diagnosis and treatment
Glaucoma is a condition that damages the optic nerve at the back of the eye, resulting in vision loss and despite being the second leading cause of blindness worldwide, it is often undertreated. It is often referred to as the "silent thief of sight" because symptoms usually do not appear until the disease has progressed significantly where peripheral and gradual vision loss are common, making it difficult for patients to detect it until it’s too late.
In an interview with HT Lifestyle, Dr Roma Johri, Glaucoma Consultant at Sri Shankara Nethralaya in Hyderabad, revealed, “Certain risk factors are associated with glaucoma, such as age, nearsightedness, family history, eye injury, certain eye surgeries and medical conditions such as diabetes and high blood pressure. The World Health Organization estimates that 4.5 million people worldwide are blind due to glaucoma, with 12 million affected by the condition in India alone, and almost 10 per cent of the population suffering from blindness caused by glaucoma.”
She opined, “Unfortunately, many people are unaware of the causes and symptoms of glaucoma. To increase the chances of early diagnosis, it is important to have an annual eye check-up with an ophthalmologist. Delayed diagnosis often results in advanced stages of the disease in many patients.”
Talking about how it develops, she explained, “Glaucoma develops when fluids produced by the eyes are unable to flow out through the trabecular meshwork located between the cornea and iris, causing the channel to become blocked. This leads to the accumulation of fluid and an increase in intraocular pressure (IOP), which can compress the optic nerve and disrupt the conversion of light into nerve signals. If left untreated, this can result in visual changes or even vision loss.”
Highlighting the types of Glaucoma, she shared, "Glaucoma can be classified into two main types: open-angle and closed-angle (or narrow-angle) glaucoma. Open-angle glaucoma occurs when the eye's fluids are unable to effectively drain from the anterior chamber, even though the angle is unobstructed. This type of glaucoma is often asymptomatic and causes gradual vision loss, earning it the nickname "silent thief of sight." Closed-angle glaucoma, on the other hand, develops when the drainage canals become blocked, preventing efficient emptying of the eye's fluids. This leads to a build-up of fluid and increased intraocular pressure (IOP). While less common than open-angle glaucoma, closed-angle glaucoma can cause sudden vision changes, such as blurry vision, halos around lights, and poor night vision. Immediate management is crucial as it may lead to total and permanent blindness if left untreated."
Diagnosis and treatment
Dr Roma Johri said, “Glaucoma tests are typically painless and brief. During the exam, your eye doctor will check your vision and use drops to dilate your pupils in order to examine your eyes. They will inspect your optic nerve for any signs of glaucoma and may take photographs to track any changes over time. They will also perform a tonometry test to measure your eye pressure, and a visual field test to determine if you have lost any peripheral vision. If your eye doctor suspects that you may have glaucoma, they may order special imaging tests of your optic nerve to help with diagnosis.”
She insisted, “It's important to note that having higher-than-normal eye pressure does not necessarily mean that you have glaucoma. Some individuals with normal eye pressure can still develop glaucoma, while others with elevated pressure may not have the condition. In cases where high pressure is present without any optic nerve damage, it is referred to as ocular hypertension. If you are diagnosed with ocular hypertension, your doctor will recommend frequent eye exams to monitor your condition. Unfortunately, any damage caused by glaucoma is irreversible. However, with appropriate treatment and regular check-ups, it is possible to slow down or prevent further vision loss, especially if the disease is detected in its early stages.”
Dr Roma Johri recommended, “The primary method of treating glaucoma is by lowering intraocular pressure. This can be achieved through various approaches, including prescription eye drops, oral medications, laser treatment, surgery, or a combination of these methods. Your eye doctor will determine the most suitable treatment plan based on the severity and progression of your glaucoma. Regular check-ups will also be necessary to monitor your eye pressure and the effectiveness of your treatment.”
Asserting that awareness holds the key, the health expert concluded, “Glaucoma awareness in developing countries such as India is significantly lower compared to developed countries. Early diagnosis and timely treatment are crucial in delaying the progression of glaucoma. Educating individuals about the condition can help alleviate blindness caused by glaucoma to some extent. This disease is a growing epidemic and a leading cause of preventable blindness worldwide. However, it is possible to prevent glaucoma from causing irreversible damage. The more people learn about glaucoma and its risk factors, the better equipped they will be to take preventive measures and seek ophthalmic care to halt the disease's progression.”