Introduction
World Glaucoma Day is celebrated on 12th March every year to make people aware of glaucoma and risk factors of glaucoma. It is aimed at early diagnosis and treatment. World Glaucoma Week is celebrated in the second week of March and is organized by the World Glaucoma Association and the World Glaucoma Patient Association. It was established on this day in 2008 to educate the public about glaucoma, also referred to as the silent vision destroyer. The disease is estimated to affect 80 million individuals worldwide, and it is the second leading cause of blindness, next only to cataracts.
Glaucoma is also found to be one of the most common causes of irreversible blindness across the globe, with around 80 million patients globally as of 2020, as estimated by World Health Organization (WHO) report. The number is also estimated to increase over 111 million by the year 2040, thereby being a priority public health concern. Also referred to as the “silent thief of sight,” glaucoma develops stealthily in its initial phases and, if untreated, results in permanent blindness. Early diagnosis, early treatment, and Glaucoma Prevention is the key to living with glaucoma. A Group of Silent Eye Diseases: Learning About Glaucoma
Glaucoma is neither an illness nor a series of eye diseases leading to damage to the optic nerve. It is urgent because it transports visual information between the retina and the brain. Damage is typically associated with elevated intraocular pressure (IOP), but glaucoma may also be accompanied by normal eye pressure.
Types of Glaucoma
Open-Angle Glaucoma (OAG)
- Most frequent type, representing close to 90% of all glaucoma in the US.
- Grows progressively as drainage canals become inefficient, resulting in high IOP.
- No symptoms at all, and routine eye checks therefore must be performed to detect it in its early stages.
Angle-Closure Glaucoma (ACG)
- Less frequent but much more sinister, with drastic potential to cause instant blindness.
- Iris blocks the drainage angle, causing sudden pressure rise in the eye.
- Needs to be treated very early so that vision is not lost irreversibly.
Normal-Tension Glaucoma (NTG)
- Occurs even if eye pressure is normal.
- Believed to be the effect of circulatory insufficiency and susceptibility of the optic nerve.
- Frequent in patients with cardiovascular diseases or hypotension.
Congenital Glaucoma
- A rare condition present at birth due to mutations of the genes that are responsible for the development of the eyes.
- Watery eyes, steamy cornea, and photophobia are the signs.
Why Early Detection Matters?
Glaucoma is a chronic disease, and 50% of industrial country glaucoma patients and 90% of non-industrial country glaucoma patients remain undiagnosed. In a projected 2022 study in The Lancet Global Health, more than 11 million are glaucoma-blind but treatable.
How Glaucoma Affects Vision?
Glaucoma typically starts with peripheral vision and eventually central vision. Glaucoma may cause total blindness if not treated. Glaucoma is advancing as follows:
- Early stage: There are no symptoms.
- Moderate stage: The vision loss starts but people do not even know.
- Advanced stage: Vision loss plays a big way in altering day-to-day life.
- End stage: Blindness due to the total loss of the optic nerve.
Chief Risk Factors of Glaucoma
Identification of the risk factors is required at the time of planning for Glaucoma Prevention. Some of the chief risk factors are:
- Age: Persons above 50 years of age have four times greater risk.
- Genetics: 10-fold risk of having one first-degree relative with glaucoma.
- Increased Intraocular Pressure (IOP): Most frequent causative factor for open-angle glaucoma by glaucoma.
- Eye Injury: Eye injury leads to secondary glaucoma due to impaired drainage of the eye.
- Diabetes and High Blood Pressure: Diabetic patients have twice the risk of glaucoma development, as stated by the American Academy of Ophthalmology (AAO).
- Long-term Steroid Use: Steroid-containing drugs have a potential to cause pressure rise in IOP, resulting in steroid-induced glaucoma.
Ethnicity
- African Americans are 6 to 8 times more vulnerable to glaucoma.
- Angle-closure glaucoma is prevalent in Asians.
- Hispanics aged above 60 years are more vulnerable than Caucasians.
How to Diagnose Glaucoma Early?
The sole absolute test to diagnose glaucoma is a thorough eye examination. Screening eye pressure alone is not sufficient for glaucoma. The most significant tests are:
- Tonometry: Intraocular pressure measurement. Normal IOP is 12-22 mmHg.
- Optic Nerve Imaging: OCT scan can detect early nerve fiber loss.
- Visual Field Test: Detects loss of peripheral vision.
- Gonioscopy: Checks whether drainage angle is closed or open.
- Pachymetry: Verifies corneal thickness, which influences measurement of IOP.
Adults 40 years and above should, The American Optometric Association (AOA) recommends, be examined each 2-year interval, and high-risk patients should be given an annual appointment.
Glaucoma Prevention: Medical & Lifestyle Approach
Glaucoma can’t be treated, though development might be prevented well with medication as well as by life change.
1. Routine Eye Test: The National Eye Institute (NEI) estimates that 60% of blindness caused by glaucoma would be prevented through regular eye exams.
2. Control of health condition: Monitoring blood glucose continuously and reduced blood pressure prevented optic nerve damage. Hypertension, in a 2019 JAMA Ophthalmology article, was found to increase IOP and therefore make one susceptible to getting glaucoma.
3. Eye protection: Eye protection using protective eyewear decreases glaucoma from trauma, the cause of 5% of all glaucoma.
4. Healthy Nutrition & Nutritional Diet: Antioxidants (Vitamin E, Vitamin C, and Zinc) shield the optic nerve from harm. Omega-3 fatty acids (in fish oil and flaxseed) enhance ocular perfusion. A 2021 British Journal of Ophthalmology study revealed leafy green food-dense diets decrease glaucoma risk by 20-30%.
Also Know: Red Eyes Explained: Symptoms, Causes, and Remedies5. Quit Smoking & Drink Caffeine
- Nicotine disrupts optic nerve perfusion.
- More than 3 cups of coffee a day can lead to an acute elevation of IOP.
6. Exercise: Aerobic exercise decreased IOP by 20% in a 2018 Harvard Medical School study.
7. Compliance Treatment: Eye drops, laser, and surgery regulate IOP. 40% of glaucoma patients in a 2023 Ophthalmology Times study were non-compliant with medication, resulting in more rapid progression.
Treatment of Glaucoma
After diagnosis, glaucoma treatment aims at the decrease of intraocular pressure through:
1. Medications
- Prostaglandin analogs (latanoprost, bimatoprost): Enhances aqueous drainage.
- Beta-blockers (timolol): Suppresses aqueous humor production.
- Carbonic anhydrase inhibitors: Decreases IOP by reducing fluid.
2. Laser Treatment
- Trabeculoplasty: In open-angle glaucoma, enhances aqueous drainage.
- Iridotomy: Creates hole in iris to reduce pressure in angle-closure glaucoma.
3. Surgery
- Trabeculectomy: Creates new drainage channel.
- Glaucoma drainage devices (shunts/tubes): Drain fluid to lower IOP.
Conclusion: Take Charge of Your Eye Care
Glaucoma is a sickness, but glaucoma may save an eye if it can be detected at an early stage and treated accordingly. Cure rests on follow-up check-up, life style alteration, and devotion. Prevent blindness may be initiated by education and making people aware. Never procrastinate, sight lost due to glaucoma cannot be retrieved, but preventative curative care can save your eyesight for life.
