World Glaucoma Patients’ Association in collaboration with World Glaucoma Association commemorate world glaucoma week in the second week of March of every year. The theme of 2016 world glaucoma week is “Beat Invisible Glaucoma’’. It is a week of glaucoma promotional activities including glaucoma march, public lecture, free glaucoma screening and advocacy to drum up support for glaucoma patients. The theme was carefully chosen to underscore the need to target glaucoma screening at people at risk of the disease such as people with family history of glaucoma, people with short sightedness, diabetics and those 50years and above. The whole idea is to expose the invisible glaucoma and offer treatment in order to stem the progression of the disease.
Glaucoma is a group of eye diseases that damage the optic nerve, the nerve that relays signals from the eye to the brain. When the nerve gets damaged, the brain will no longer receive information from the brain. The exact cause of the damage is not known, however, high eye pressure has been recognised as a major risk factor for the optic nerve damage. If the high eye pressure is left untreated, it will lead to gradual visual impairment and blindness. The visual loss in glaucoma is gradual and painless that is why glaucoma is called “silent thief of sight’’.
According to data from National Blindness and Visual Impairment Survey, 1.1-1.4 million Nigerian adults have glaucoma and majority of them were not aware they have the disease. Furthermore, one in every 20 Nigerian aged 40 years and above has glaucoma. One in every five of people with glaucoma in Nigeria is blind from the disease. The current situation is worrisome and a source of concern, more so loss of vision in glaucoma is irreversible and the disease is not curable but treatable.
Millions of dollars is being sunk into glaucoma research annually yet there is no definitive cure to the disease. Africa has higher prevalence of the disease compared with other regions. Glaucoma occurs at younger age and progresses faster in people of African origin in contrast with Caucasians where the onset is much later in life and has an indolent course.
Glaucoma in the initial stage has no symptoms but in later stage of the disease the symptoms include seeing rainbows around light, smoky or cloudy vision. Others are bumping into objects and early morning ocular discomfort.
There are different treatment options for glaucoma. The choice ranges from medical, surgical to laser treatment. All of them achieve the same thing i.e. reduction in eye pressure. When the eye pressure is reduced to a level consider safe to a patient eye, further deterioration in sight will be halted. The treatment is individualised and it’s undertaken in a step wise manner. In some people, Surgery is chosen first while in others medical treatment is the first line. Laser is used when medical treatment fails and in some individual combined treatments e.g. medicine and surgery are needed to control the eye pressure. The choice of best treatment modality for a particular person lies on the hand of the attending ophthalmologist.
The only way one can beat glaucoma is through undertaking regular eye examinations. It is recommended that people at risk of having glaucoma (People with family history of glaucoma, short-sighted individuals, diabetic and those older than 40 years) to have comprehensive eye examination at least once every year. For those who already have glaucoma, they can prevent themselves from going blind through being adherent to their medications and follow up visits. They should avoid the use of over –the- counter drugs.
The management of glaucoma in developing country like Nigeria is not without constraints. The challenges include late presentation. Many people presented at a time when the disease is already advanced. Others include poor awareness about the disease, high cost of medication, poor adherence to treatment and follow up as well as lack of facilities especially in rural areas. Inadequate manpower and lack of facilities for visual rehabilitation are among the limitations militating against provision of glaucoma services in Nigeria. These challenges are not insurmountable and some can be tackled through awareness creation about glaucoma, provision of subsidised drugs, training and retraining of manpower as well provision of equipment for early glaucoma detection and treatment .In conclusion, as you are reading this piece, I enjoin you to check your eyes for glaucoma as we commemorate world glaucoma week.
Dr Abdullahi Sadiq Mohammed
National Eye Center, Kaduna. Nigeria.