Glaucoma – you could be losing your sight and not know

glaucoma

World glaucoma week will be celebrated this year from the 9th to 14th of March; it is a joint international initiative of the World Glaucoma Association and the World Glaucoma Patients Association, to raise awareness of glaucoma. This year’s theme is “Beat invisible Glaucoma”. In order to preserve your sight you must be educated about the facts surrounding glaucoma and how it can be treated.

Glaucoma is a serious eye disease that can potentially steal your vision. Often Glaucoma is asymptomatic and can suddenly result in vision loss and eventually blindness if not treated properly. Usually there is a clear fluid in your eyes called intraocular fluid that is continually produced and needs to continually be drained from the eye, to allow your eye pressure to remain normal and allow your eyes to work properly. However in some cases your eye drainage system becomes clogged and the fluid cannot be drained as it should. This causes your eye pressure to become very high which can in turn damage your optic nerves and gradually lead to blindness. Your peripheral or side vision is usually first affected and over time you can lose your central or direct vision also.

We are all at risk to develop glaucoma but the following groups are at a higher risk:
Persons over 40 years old, people of African descent, persons with myopia, people of Asian descent, persons with thin central cornea, Hispanics in older age groups, persons who use steroids and persons who have a family history of glaucoma.

There are various types of glaucoma that can affect you, however the two main types are: open angle and angle-closure glaucoma. Open Angle is the most common form and is responsible for at least 90% of all cases reported. It is caused when drainage canals slowly clog, thereby increasing your eye pressure. This condition is irreversible and lifelong and often has no noticeable signs or symptoms. However, regular eye examinations which would allow for early detection can allow you to successfully treat and control the disease.

The other main form of glaucoma is angle- closure glaucoma or narrow-angle glaucoma and is a very rare form. It is characterized by the blockage of drainage canals and the sudden rise in eye pressure. It develops very quickly and comes with noticeable symptoms that require immediate medical attention to prevent complete, irreversible blindness. This form is usually signaled by your eyes turning red, headaches, intense eye pain, nausea, blurred vision and seeing rainbows around lights at night. This type of glaucoma requires surgery to treat the problem and it will be helpful once immediate attention is given.

Other types of glaucoma are: secondary, pigmentary, normal-tension, congenital, exfoliative, neovascular, uveitic and traumatic glaucoma.

Glaucoma is typically treated by using medications that work to decrease the amount of fluid made by the eye or help to better drain the fluid in your eyes. This would serve to control your eye pressure and by carefully and correctly following your doctor’s instructions these medication will prevent your glaucoma from getting worse. Laser or conventional surgery can also be used to treat the more severe form of glaucoma. Counseling is also available to patients to help them achieve a better understanding of the disease and how to manage it.

In order to preserve your sight and beat glaucoma before the silent thief of sight snatches yours away, consult an ophthalmologist regularly as glaucoma usually comes with no signs. Remember regular checkups and controlled treatment can allow you to see for many years to come.

For more information please see www.wgweek.net or please contact Dr. Benet Henry, Consultant Ophthalmologist, at optipharminc@gmail.com.

 

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7 Comments

  1. March 11, 2014

    There is NO cure for glaucoma. Eye drops is one solution, but that do not even work.

  2. Francisco Telemaque
    March 11, 2014

    Glaucoma is a group of diseases of the eye characterized by increased intraocular pressure, resulting in pathological changes in the optic disk, and typical visual field defects, and eventually blindness if it is not treated successfully. Glaucoma (glaucomatous), is responsible for approximately 12 percent of all cases of blindness, and strikes more than 2 percent of all those over forty years of age, at least in the United States. It rarely occurs in anyone under the age of 40. The actual cause of the disease is unknown, however there is a hereditary tendency toward the development of most common forms of glaucoma. Early detection, and treatment are essential to prevention of permanent loss of vision. It is imperative that all persons over the age of 40; and especially those with a family history of glaucoma should have their intraocular pressure checked once each year.

    The normal eye is filled with aqueous humor in an amount carefully regulated to maintain the shape of the eyeball. In glaucoma, the balance of this fluid is disturbed; as such fluid is formed more rapidly than it leaves the eye, hence pressure builds up; the increased pressure damages the retina, and disturbs the vision: i. e., by loosing side vision, and if he pressure is not relieved by proper treatment, the pressure will eventually damage the optic nerve, hence interrupting the flow of impulses, resulting in blindness.

    Classification: Glaucoma can be divided into three major types; adult primary glaucoma, secondary glaucoma, congenital glaucoma. The most common type of adult primary glaucoma is open angle glaucoma, in which there are open chamber angles; nevertheless, there is resistance to the outward flow of aqueous humor; this type of glaucoma, also called chronic simple glaucoma, is characterized by very few symptoms in the early stages, and so many people have the disease and not knowing they have it. There may be hazy vision, and some mild discomfort in the eye, and later there is a slight noticed loss of peripheral vision. As the disease progresses there will be reduced visual acuity, and greatly increased intraocular pressure that may cause the appearance of colored rings, or halos around bright objects.

    Another form of adult primary glaucoma is angle closure glaucoma, (that is narrow angle glaucoma), which can be either acute, or chronic; in this type of glaucoma the chamber angle is narrowed, or completely closed because of forward displacement of the final roll, and root of the iris against the cornea, this closure obstructs the flow of aqueous humor from the eyeball, and permits a buildup of pressure. Secondary glaucoma occurs as a result of a variety of disorders, such as uveitis, neoplastic disease, trauma, and degenerative changes in the eye. Congenital glaucoma is due to the defective development of the structures in and around the anterior chamber of the eye, and results in impairment of the aqueous humor.

    Treatment: Open angle, or chronic simple, glaucoma is treated medically through the use of beta blockers such as Timoptic, miotics to facilitate aqueous outflow, and carbonic anhydrase inhibitors to reduce the rate at which aqueous humor is produced. The patient must be informed about his/her problem, and made to understand they must continue the prescribed medications for the rest of their life. An alternative treatment is laser photocoagulation of the angle.

    I shall return to complete it, in a following episode!

    Francisco Etienne-Dods Telemaque

    • March 11, 2014

      Mr Telemaque, how about requesting the permission from DNO to have your own column on topics of your choice.
      Every column that is written, no matter the subject, u inject so much information to it and sometimes repeat what is already posted.
      We already know that u are smart with a wide knowledge base , so let the writers enjoy the credit for their posts or columns without your long added and same rewritten information ..

      credit for his

      • Francisco Telemaque
        March 11, 2014

        If you could read and understand what you read, you would have noticed I expanded on basically all of what Benet Henry wrote, and more there is more detail in what I said, and even the good doctor cannot refute that.

        If DNO post my last submission, and you read it that will cause you to put your foot in your mouth, and chew on it.

        The man spoke about headaches, and pignantary, and normal-tension, I named the three most common types of glaucoma, and expanded on them according to my knowledge, you did not read where I said anything about people using steroids, as he commented on; so how can you claim I am repeating what the man wrote?

        Insert everything I wrote, and what he wrote into a proof reader, and see if the results are the same. You are just angry you cannot submit anything close to what I wrote. And by the way I do not want a column on DNO, for your information I had an educational Website which I closed last year after maintaining it for more than twenty years.

        Ninety per cent of what I had uploaded on my site was pertaining to Health Science, and medicine, If I need a column I can build me a Website before the week is out and write anything I wish on it!

        The domain of my Website was http://www.yvonnedods.com

        Francisco Etienne-Dods Telemaque

    • Francisco Telemaque
      March 11, 2014

      We are still addressing the treatment of glaucoma; the focus is now “Angle closure glaucoma which is usually treated surgically. If the condition becomes acute, a medical, and surgical emergency exists; if the excessive intraocular pressure is not relieved promptly by medical, and surgical means, nerve fiber in the optic disk are destroyed, and vision will irretrievable lost. Laser surgical techniques for relief of intraocular pressure include gonioplasty, iridotomy, and trabeculoplasty. In gonioplasty a series of microscopic lesions are created in the periphery of the iris; as the lesions heal, contracting scar tissue draws the iris away from the cornea, the anterior chamber angle widens, and the anterior chamber deepens, thus reducing resistance to the outflow of the aqueous.

      Iridotomy involves perforation of the root of the iris, which provides an additional route for the escape of excess aqueous from the posterior to the anterior chambers, and the trabecular meshwork. In trabeculoplasty the spaces of the trabecular meshwork are enlarged by a series of microscopic lesions; eventually scars form, and contract, thus widening the spaces, and allowing better aqueous flow. Laser surgery can be done on an outpatient basis; an local anesthetic is utilized, and patients feel only some mild pricking sensations as the laser pulses strike, and coagulate tissue. A retrobulbar anesthetic may be used to immobilize the eye during laser surgery.

      Early diagnosis and prompt treatment in order to prevent the serious consequences of increased intraocular pressure are an major concern of health care professionals, Screening techniques for early detecting include measurement of intraocular pressure in populations most at risk; verification of the diagnosis of glaucoma is necessary once suspected cases are found. Persons most at high risk for glaucoma are diabetics, persons with hypertension (that is high blood pressure), and unfortunately Black people among whom seems to have an high incidence rate of glaucoma related blindness that is perhaps eight times more than non-blacks; individuals with a family history of glaucoma, persons with facial hemangioma, or other nevi, and also victims of eye injury.

      Patients who have symptoms of glaucoma, and are being treated with drugs must be informed of the nature of their eye disorder; such as the expected effects of each medication, and the importance of following the regimen of care. Some patients will experience unwanted, undesirable side effects from these medications, they are directed to report the side effects promptly so that the medication my be evaluated by the prescribing ophthalmologist. The combinations of drugs used to treat glaucoma in individual patients vary considerable; in many cases the patients may take between four, or five different drugs. These drugs are prescribed to either enhance the outflow of aqueous, or to decrease the production, or both.

      Miotic drugs such as pilocarpine (Ocusert), and phospholine iodide facilitate aqueous outflow by stretching the iris away from the trabecular meshwork An additional effect of pilocarpine is to constrict the pupil, which reduces visual acuity. Epinephrine, acetazolamide (Diamox), methazolamide (Neptazane), and the beta blocker timolol (Timoptic) decrease production of aqueous.

      I could end it by going into prescribed eye-drops, and oral medications taken on an uninterrupted basis, but I doubt that is necessary at this point.

      Francisco Etienne-Dods Telemaque

  3. Andrew
    March 11, 2014

    But remember Dominicans, you will not get all the help you might expect. My neighbor – a pensioner -has glaucoma, only diagnosed 3 years ago because we took him to a private appointment ($120), as the hospital did not have the equipment to test for it. Damage was then stopped by using drops ($100 per month) bought by us because they are not subsidized by the government (like heart and diabetes meds are). In the north we used to have just one visit a month from the consultant ophthalmologist, although this was often cancelled – now there are none. Recently my neighbor saw the VOSH team (as he has not been able to see his ophthalmologist for 2 years) and his eyes have gotten worse, so he now has to go for another private appointment ($120) to asses the damage. And in 3 years he has never received any counseling. So if you are unlucky enough to get this disease, you need deep pockets or friends with money.

    • Andrew
      March 11, 2014

      Oh, and also live in Roseau, because that’s the only place you can see an ophthalmologist

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