See the big picture: Glaucoma & its genesis

English

Ravina danced in ecstasy at the elaborate Sangeet ceremony, organised on a lavish scale, at a magnificent beach resort, as her elder sister got married to her Prince Charming. It was a perfect setting and seemed to picture perfect, but would it have a fairytale ending?

Ravina felt delighted and proud that she was wearing a lovingly embroidered, zari-embellished ghagra created by her great grandmom and passed on from generation to generation. Not only was it in her possession, now, but she was wearing it on such a grand occasion; it fit her beautifully and accentuated her slim waistline.

But the petite damsel did not know about the debilitating blindness, that seemed to be lurking dangerously close and had no inkling of a terrible condition like permanent vision loss – the horrible fate that awaited her.

Causes of Glaucoma

• Trauma or injury by a blunt object to the eye
• Hereditary
• Family history
• Diabetes
• Severe eye inflammation or infection
• Blocked blood vessels
• Chemical injury
• Eye surgery for other eye-related ailments
• High fluid pressure inside the eye

Ravina was unaware of glaucoma being a stealthy robber that crept up on unsuspecting people and stole their vision. Most people are unaware and youngsters particularly do not bother about regular eye check-ups which could detect this menace early.

For Ahmed Ali, the reasons were different. So were the symptoms.

Symptoms of Glaucoma

• Nausea & vomiting
• Tunnel vision
• Redness in the eye
• Loss of vision
• Lights seem to cast halos

As a child, he had always suffered some eye problem or the other. Red, itchy eyes were so common that he can hardly recall a span of a few months when he would be free from eye ailments. Coming from an extremely poor financial background, Ahmed Ali had continued to take the eye drops given to him given to him by his Ophthalmologist, all through his teens, into adulthood and upto now when he was almost 42 years old. In fact, it was a wonder that he could see at all and hadn’t lost his sight. It was only because of his son prodding him to visit a municipal hospital that he sat facing an eye surgeon who was horrified to discover the extent to which the poor man had to neglect looking after his eyes, due to poverty.

The Opthalmologist checked his IOP and enquired about having headaches, or eye pain.

What is IOP?

Intraocular pressure is known as IOP. A sudden rise or spike in this pressure, sometimes even within hours, results in acute angle closure, and is also referred to as narrow-angle glaucoma. Far-sightedness, cataracts, clouding of lens inside the eye are other fallouts. What needs to be dealt with, here, is the iris blocking the way for the fluid in the eye to be drained out. The pressure can cause irreparable damage to the optic nerve (which transmits messages to the brain) leading to permanent blindness.

Diabetic retinopathy, tumor ocular ischemia or narrowed blood vessels leading to the eye, uvetis, meaning eye inflammation, are few medical conditions associated with acute angle glaucoma.

On the other hand, wide-angle glaucoma is more prevalent. Also, like in Ahmed Ali’s case, pressure builds up gradually over time.

Risk factors of Glaucoma. 

There are certain predisposing factor which increase the chances of getting glaucoma:

• Being of African-American, Irish, Scandinavian, Japanese, Russian, Inuit or Asian origin
• Using medicines such as prednisone
• Being older than 40 years

Diagnosis and Treatment

Drops are used as the first line of treatment to dilate the pupils. A test called tonometry is also required to check eye pressure which determines whether side or peripheral vision is lost.

While eye drops decrease fluid formation, there may be certain side effects such as an allergy, irritation or stinging.

In a type of microsurgery, a procedure called trabeculectomy is carried out which entails implanting a tube to drain out fluid. At times, it has to be redone, as it fails to yield the desired result.

Congenital glaucoma among infants is also treated with surgery. It is vital to remember that while glaucoma cannot be totally prevented, it can be greatly controlled with early diagnosis.

Glaucoma is one of the leading causes of blindness for older people and usually have no symptoms. The vision loss due to glaucoma can’t be recovered, so it needs to treated as early as possible. If you experience any of the above symptoms, visit your nearest Eye Hospital or an Ophthalmologist close to you.