Timothy

Below is a speech delivered by Minister of Health, Julius Timothy, in observance of Glaucoma Week.

World Glaucoma week is being observed from March 11 – 17, 2012 under the theme “Don’t let glaucoma darken your life” to raise public awareness on this very important eye disease.

Glaucoma is defined as a progressive damage of the optic nerve associated with characteristic loss of peripheral or side vision before progressing to total blindness.  The optic nerve transmits the visual image from the eyeball to the brain.

Glaucoma is lifelong and non-infectious making it a chronic non-communicable disease.

Globally glaucoma is the second leading cause of blindness after cataracts, but it poses a greater public heath challenge as blindness from glaucoma is irreversible and as the world’s population ages the number of persons with glaucoma will increase.  It is the leading cause of irreversible blindness.

In 2006 it was estimated there were about 67 million people in the world with glaucoma and 10% of them were blind due to glaucoma.

In the Caribbean region including Dominica glaucoma is one of the five preventable causes of blindness listed in their Vision 2020 “the right to sight” strategy to eliminate preventable causes of blindness by the year 2020.

The incidence and prevalence of glaucoma and blindness as a result of glaucoma in Dominica are unknown.  The Barbados eye study conducted 1987-1992 in a population of predominantly black people age 40 -84 and the Barbados Incidence Study of Eye Diseases (BISED I, 1992-1997) have provided data about glaucoma in black people.

The Barbados eye study found the prevalence of open angle glaucoma  to be one out of eleven for persons 50 years and older increasing to one out of six for persons 70 years and older.

As a result, it can be estimated that there are over 1500 persons living with glaucoma in Dominica.  There are more men 8.3% compared to women 5.7% with glaucoma.  Of these about 10% or 150 are blind because of glaucoma.

It is most prevalent among black people.  The risk increases with age, family history of glaucoma, diabetes mellitus, myopia and those with elevated intraocular pressure.  About half of persons with glaucoma do not know they have this disease.

Glaucoma cannot be cured but loss of vision can be prevented by lowering the intraocular or eye pressure.  The lowering of intraocular or eye pressure can be achieved with eyedrops and surgery.

The government of Dominica has made specialist eye care available and accessible to everyone free of charge in the Primary Health Districts and free to those 18 years and younger and 60 years and older at the Princess Margaret Hospital.

All of the eyedrops to treat glaucoma can be obtained in Dominica. Some of the eyedrops not offered free of charge in the public sector are offered at cost price, almost 50% cheaper than in the private sector at the Central Medical Stores, Princess Margaret Hospital.  Consideration is being given for all glaucoma eyedrops to be included in the government drug formulary so that they can be obtained free of charge throughout the Primary Health Districts.  This will also remove the need for patients to travel to Roseau to purchase their glaucoma eyedrops.

However, this is estimated to cost the Ministry of Health an additional EC$300,000.00 per annum.  This underlies the burden of this disease on the public purse.

However this can no way match the burden of blindness.

Visual loss and blindness are associated with adverse implications for health and well-being, including reduced quality of life, functional and cognitive decline, work and academic underperformance, anxiety, depression, inability to drive, reduced social interaction, increased frequency of falls and fractures, loss of independence leading to institutionalization or nursing home admission, and perhaps even higher risk of early mortality. It is not often recognized that the magnitude of adverse impact on functional status and well-being due to irreversible visual loss and blindness are comparable to that attributable to major medical conditions.

Visual impairment also leads to increased direct and indirect costs at the individual level, as well as to increased costs to healthcare systems and there are clear benefits to interventions that prevent or delay vision loss.

The following recommendations are proposed:

1.    Patients are advised from the age of 40 to have regular eye examinations.

2.    Patients diagnosed with glaucoma should adhere to using their eyedrops as prescribed and keep their follow-appointments with their Eye specialist.
Relatives should assist patients diagnosed with glaucoma: helping to pay for the medications as needed, putting the eyedrops for them if this poses a challenge physically, reminding them of their appointments and providing transportation for their follow-up eye visits.  This help is important as a significant number of glaucoma patients are older persons with many other health problems.

3.    Relatives of patients with open angle glaucoma are at an increased risk of developing glaucoma.  These relatives should have regular eye examinations from the age of 35.

4.    Patients who sustained injury to their eyes and those who use any type of steroid medications over a long time are at risk for developing glaucoma and hence should have regular eye examinations.

In conclusion glaucoma, the silent thief of sight, can darken your life because it can cause irreversible blindness. It cannot be cured but it can be controlled. The earlier glaucoma is detected and treated the greater the chance of preventing blindness.

You have been informed!

Don’t let glaucoma darken your life!