Glaucoma: Watch Out for this Vision Thief

Glaucoma is the second most common yet treatable cause of blindness. At the age of 60 years, 1 out of eleven people are likely to have glaucoma. With no visible signs till very late glaucoma is known to be a silent thief of vision. On the occasion of World Glaucoma Week, Nidhi Chawla spoke to Dr. Meena Gopinath Menon of Sankara Eye Hospitals, Bangalore to find out how to safeguard yourself against this silent ailment.

Lalitha Ramakrishnan is a glaucoma patient who discovered the condition only when the symptoms manifested in grave form and she could not see the vehicles coming from her left side till they were in front of her. A prompt consultation with her ophthalmologist revealed that her left eye had been badly impacted and she had lost 85 per cent of her vision. Three surgeries and twenty three years later and with a lifelong prescription of eye drops, Ramakrishnan has learned to cope with her ailment. She is unstoppable and is still an avid blogger and a knitter.

Unfortunately, this condition has been passed onto one of her daughters, Viji Venkatesh. Venkatesh has about 25% vision in her right eye and about 95% in the left eye. Having ignored the fact that glaucoma can be hereditary, Venkatesh too realised it when she found she was tripping and falling down often because she could not judge the ground level correctly and she felt very uncomfortable in dim light. ?Except for being unable to gauge the depth of steps and not able to make out level differences on the ground if I am not looking where I am walking, I am doing fine?, says Venkatesh.

What is Glaucoma?

Glaucoma is an eye-condition caused by increased pressure on the optic nerves which can lead to permanent damage of the nerves, hence leading to blindness if not treated well in time.There are 12 million people are 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 been done already. Only in very few cases one may experience symptoms like sudden ocular pain, progressive loss of vision, frequent headaches, seeing halos around lights or feel pain and pressure around the eye ball along with nausea and vomiting and would require an immediate consultation with an Ophthalmologist. ?In our experience in more than fifty per cent cases Glaucoma is detected during general OPD or routine check-ups?, says Dr. Menon.

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.

Who is at risk?

Anyone and everyone but people above the age of 40 are more prone to it. The risk increases with age and certain risk factors like family history and medical conditions like diabetes, hypertension, hypothyroidism and myopia increase the chances of glaucoma manifold.

Treatment

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. ?Depending on the severity of the condition administration of eye drops, laser surgery or invasive surgery may be recommended?, adds Dr. Menon.

Talking about her line of treatment Venkatesh says, ?My treatment began with laser surgery and a regimen of drops but the pressure kept increasing so underwent Trabeculectomies (invasive surgery) in both eyes and an additional corrective surgery in my good eye a few months ago. As of now I have no treatment underway?.

However the key to the treatment of glaucoma is timely detection. Hence 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 3 ? 6 months depending on the severity of the condition and compliance of 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 as other than your peripheral vision contrast is impacted too and also one should avoid driving.

With small lifestyle changes and with some help from family and friends one can manage leading a normal life even with glaucoma. In fact recently launched vision rehabilitation centre at Sankara Eye Hospital assists glaucoma patients and other vision impaired individuals to adapt to the changes in vision and understand the changes in lifestyle needed.

Sharing her experience Venkatesh 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 these fancy 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 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, take photographs etc.? she adds on.

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

Do share your experiences with Glaucoma for the benefit of others and in case you have any questions for Dr. Meena Gopinath Menon ask here and we shall get them answered.

We would like to thank Viji Venkatesh, Country Head ? Max India Foundation and her surgeon Dr. Rajul S. Parikh for their inputs.