Glaucoma: The Silent Vision Thief

Glaucoma is the second most common yet treatable cause of blindness. At the age of 60 years, 1 out of eleven people is likely to have glaucoma. On World Glaucoma Week, here’s how to safeguard yourself against this silent ailment.

Lalitha Ramakrishnan realized something was wrong with her vision when she couldn’t see the vehicles coming from the left side and only spot them when they were in front of her. This alarmed Ramakrishnan enough to visit an ophthalmologist. Unfortunately, the diagnosis was Glaucoma, a condition that damages the optic nerve. The doctor also revealed that she had lost 85 percent of her vision in her left eye. Over the years, after surgeries and a lifelong prescription of eye drops, Ramakrishnan has learned to manage her ailment. Now at 94, she reads the newspaper every morning, watches television to her heart’s content, and has only stopped knitting because of her age and not eyesight.

Ramakrishnan was lucky to have caught it on time because Glaucoma can result in vision loss and possible blindness. It occurs due to high intraocular pressure or the pressure of fluid inside our eyes.

In some cases, early-onset Glaucoma can be hereditary, like with Ramakrishnan’s daughter Viji Venkatesh. Venkatesh, 68, has about 25 percent vision in her right eye and about 95 percent in the left eye. Having ignored the fact that glaucoma can be hereditary, Venkatesh too realized it when she was tripping and falling down often because she could not judge the ground level correctly and felt uncomfortable in dim light. “Glaucoma has no symptoms in the early stages and could have affected much of your optic nerve permanently before you notice any visual problems,” she says.

Today Venkatesh is an advocate of preventive and early detection measures that should be part of one's mandatory health check-up to avoid Glaucoma. Region Head, South Asia, The Max Foundation, she has a huge social media following and does not fail to spread awareness about Glaucoma on every Glaucoma Awareness Week. She continues to be regular with her follow-up visits to the surgeon, even a decade after diagnosis.

What is Glaucoma?

Glaucoma impacts the optic nerves impairing the peripheral vision initially, leaving only a small central vision. However, in extreme cases, this may be impacted too leading to blindness. And it isn’t a rare condition. There are 12 million people affected with glaucoma in India. Of this, 1.5 million people are blind.

Glaucoma can go unnoticed in the initial stages as it is painless and manifests only in later stages when extensive damage has already occurred. Only in very few cases, one may experience symptoms like sudden ocular pain, progressive loss of vision, frequent headaches, seeing halos around lights, or feeling pain and pressure around the eyeball along with nausea and vomiting.

“In more than fifty percent cases, Glaucoma is detected during general OPD or routine check-ups,” says Dr. Meena Gopinath Menon of Sankara Eye Hospitals, Bengaluru.

Who is at risk?

People above the age of 40 are more prone to glaucoma though it could happen to a younger person too. The risk increases with age and factors like family history, medical conditions like diabetes, hypertension, hypothyroidism, and myopia. Because of the silent way it can creep up on you, Venkatesh calls glaucoma a vision thief. 

“If you haven't had an eye test in the two years, make it your priority to do so. It is quick, painless, and may just save your sight.”

Once diagnosed with glaucoma, she convinced her whole family to undergo a check-up. Her younger son showed very early signs of the disease. “Today he has regular check-ups done post laser surgery which has arrested any possible further deterioration.”

Treatment Options

The onset of glaucoma cannot be prevented and the damage caused is irreversible. But the good news is that its progression can be curtailed through timely treatment and you can lead a normal life. “Depending on the severity of the condition, administration of eye drops, laser surgery, or invasive surgery may be recommended”, adds Dr. Menon.

“My treatment began with laser surgery and a regimen of drops but the pressure kept increasing so I underwent Trabeculectomies (invasive surgery) in both eyes and additional corrective surgery in my good eye. As of now, I have no treatment underway.” Venkatesh shares.

Dr. Menon recommends a comprehensive eye examination comprising of dilation of pupils once every two years for people above 40 and every year for people above 60. People with Glaucoma may be asked to get an eye check-up done every three or six months depending on the severity of the condition and compliance with medication.  

Impact on day-to-day living

With the peripheral vision getting impacted the objects appearing on the sides may not be visible and this can lead to mishaps if not careful. Hence Dr. Menon advises glaucoma patients to not venture out alone in the dark. One should also avoid driving.

With small lifestyle changes and with some help from family and friends, one can manage to lead a normal life even with glaucoma.

Sharing her experience Venkatesh, who is on the move constantly because of her work says, “My eyes do tire easily and I continue to trip and fall. Unless I am very careful I am unable to bear the glare of bright lights and gleaming floors and glass doors are a pain to navigate. I have consciously slowed down my gait and have no qualms of being a slow mover. I keep my hands free to hold on to rails on escalators and stairs. Other than this I go about all my business pretty well. I read, work on all my devices and take photographs!”

Acknowledging and informing others about your condition is the foremost and most important step of dealing with glaucoma, says Dr. Menon. The second step is following the recommended medication regimen. “With these two taken care of, you can continue to live your life fully even with glaucoma. I have patients who continue to do wildlife photography and crochet work.”  

Image courtesy:  Cover image by Tobias Dahlberg & CommsEditors101 from Pixabay 

Do you maintain a regular eye check-up routine or lead a normal life with Glaucoma? Do share your experience for the benefit of others in the comments below.