- Published on Thursday, 02 March 2017 08:32
- Written by Thorsten Marquardt
Glaucoma, the silent thief of sight, is a group of diseases caused by damage to the optic nerve in the eye.
Without any warning signs or symptoms it will slowly take away the affected person’s eye sight and can even cause blindness if not treated appropriately.
Tanaletchimy Rajaratnam, 63, felt completely healthy and had no symptoms at the time she was diagnosed with high eye pressure during a routine eye screening in the UK.
With high eye pressure being the number one cause for glaucoma, she decided to start the treatment right away.
Taking the risk seriously, going for regular checkups and starting with the treatment early enough helped keeping the disease’s progress at bay.
This is the reason why today, 10 years after she was diagnosed with glaucoma, her eye sight has not been significantly affected.
Without early detection and swift action, this could have played out very differently.
Another patient’s son, Mr Wong, told MalaysianDigest, at the Tun Hussein Onn National Eye Hospital that his 75 year old father had been affected by glaucoma for a long time without even noticing it.
Only after the disease had already severely damaged his eyes and even started to cause pain, he finally consulted a doctor.
Without appropriate treatment, he is now at risk of going blind.
Before being diagnosed with the disease, like most people, both patients weren’t even aware of its existence. Like many other glaucoma patients in Malaysia, Wong and Tanaletchimy accounts of the onset of the disease highlights the invisible nature of this condition until it is too late.
The Malaysia Glaucoma Society had produced the following public announcement about this disease a few years back to create awareness of this 'silent thief of sight'.
The World Glaucoma Week held in March each year takes place on 12 to 18 March 2017 and to help raise awareness, we have decided to highlight this often 'invisible' illness and look at a local eye hospital's role in helping glaucoma patients.
The Silent Thief Of Sight
If the optic nerve that connects the eye to the brain is too damaged, it will not be able to send an accurate and complete picture to the brain causing reduced eye sight.
This results in people having blurry vision and a restricted field of view or missing objects in their view.
Glaucoma usually comes without any symptoms and often stays undetected for a long time.
Not always, but very often, glaucoma is caused by high eye pressure damaging the optic nerves.
To be more specific, glaucoma usually develops when the production of an eye fluid called aqueous humour either increases or fails to drain properly.
This causes the pressure in the eye to rise which can damage the fibres in the optic nerve resulting in interruptions to the transmission of visual messages to the brain.
Eye drops are used to reduce the eye pressure and keep it stable to prevent further damage to the nerves.
Eye pressure is the main cause for glaucoma, but not required for its development.
People with normal eye pressure can still be affected, while people with high eye pressure are more likely to be at risk but don’t necessarily develop the disease.
It is estimated that half of the people affected by glaucoma do not know that they have it, which is a serious problem because if left undetected and untreated it can lead to blindness.
According to the World Health Organization, Glaucoma is the second most common cause of blindness worldwide and it is estimated that 4.5 million persons globally are blind due to glaucoma.
“If left untreated, most types of glaucoma progress (without warning nor obvious symptoms to the patient) towards gradually worsening visual damage and may lead to blindness,” states the World Glaucoma Association.
Since there is no cure, the damage caused to the optic nerves and the reduced eye sight are irreversible, therefore it is important to detect it early.
“There is no cure for glaucoma as yet, and vision loss is irreversible. However medication or surgery (conventional or laser) can halt or slow-down any further vision loss. Therefore, early detection is essential to limiting visual impairment and preventing the progression towards severe visual handicap or blindness,” states the World Glaucoma Association.
“Everybody Is At Risk Of Glaucoma”
Datuk Dr. Linda Teoh, a full time consultant ophthalmologist and glaucoma specialist at the Tun Hussein Onn National Eye Hospital (THONEH), told MalaysianDigest that everybody can be affected by glaucoma.
There are certain risk factors, like for example high eye pressure and a family history, but the disease can affect anyone.
“It is not just about the eye pressure. The eye pressure might be normal but the person can still develop glaucoma. There can also be people with high eye pressure but no glaucoma. Too many people look only at the eye pressure,” she said.
People with high eye pressure are at a much higher risk of getting glaucoma and it is generally assumed that people with a family history of glaucoma already have a 1 in 4 chance of developing the disease.
There are, however, many other factors that come into play.
Everybody is potentially at risk of developing glaucoma, but there are certain risk factors that increase the likelihood.
People above the age of 60, people with diabetes, people who have used steroids for a long period of time and people with physical eye injuries are also at a higher risk.
Some ethnicities are more prone to the disease than others.
The Glaucoma Research Foundation found that African Americans are more likely to be affected by glaucoma than Caucasians.
The ingredients of certain weight loss appetite suppressant pills are also linked to an increased risk.
In Malaysia around 1.8 percent of the population is affected by glaucoma and, according to surveys, only 21 percent of the population are even aware of the disease.
Since glaucoma is very unpredictable, can affect anyone and comes without warning, routine eye checkups, measuring eye pressure and conducting visual field tests are crucial in detecting and treating the disease early enough to avoid major irreversible damage to the eye sight.
Education And Cooperation Between Doctor And Patient Are The Key To A Successful Treatment
When it comes to treating glaucoma, it is very important that the patient and the doctor are on the same page.
Since glaucoma is a disease that continuously gets worse while causing irreversible damage, regular checkups and adjustments to the treatment are very important.
In order to keep the disease from progressing, it is required to keep the eye pressure low and stable.
“Glaucoma is actually a group of diseases causing damage to the optic nerve of the eye. By controlling the eye pressure, the drops can slow down the progress of glaucoma,” Dr. Linda explained.
“I think what is important is education. Patients should know the nature of the disease and understand how it progresses.”
Despite the aggressive nature of the disease and lack of cure, it is possible to prevent the loss of eye sight through appropriate treatment.
This, however, can be costly, time consuming and requires the patients to actively take an interest in informing themselves about the disease and be compliant with their medication.
Dr. Linda thinks that a lack of education and knowledge about the disease leads many patients to be neglectful and hamper the effectiveness of the treatment.
“They feel there is no improvement in spike of treatment. They fail to understand the nature of the disease. Then they blame the doctor if they don’t get better. They always want to improve, but what they don’t understand is that Glaucoma cannot be improved; its progress can only be slowed down. What they need is education,” she said.
In order to successfully treat the disease and prevent it from progressing, patients have to go for regular checkups, use the prescribed medicine correctly, meet doctors regularly to adjust the treatment based on changing conditions and undergo surgery (to control the eye pressure) if the necessity arises.
The drops used to reduce the eye pressure, for example, have to be adjusted regularly depending on whether the eye pressure are effectively controlled in order to avoid fluctuations that damage the optic nerve further.
Dr. Linda opined that patients who are either too uninformed and ignorant about the disease or don’t trust the doctors are more likely to fail at properly treating the disease.
Tanaletchimy, who managed to slow down the progress of the disease by being very proactive and engaged with her doctors also sees cooperation between doctors and patients as the most important factor.
“Just listen to what the specialists have to say. They are the experts. You must have confidence in the doctor and just follow what the doctor suggests,” she said.
According to Dr. Linda, education, cooperation with the doctor, early detection and early treatment are the most important factors in successfully treating glaucoma.
In conjunction with the World Glaucoma Week 2017 starting from March 12, the Tun Hussein Onn National Eye Hospital (THONEH) will be hosting an open day on 22 March 2017 (Wednesday).