World Glaucoma Week 8th to 14thMar 2020

 Dr. K. Jayamahesh, Consultant OphthalmologistKIMS ICON Hospital, Vizag.

 World Glaucoma Week will be celebrated from 8thMar to 14thMar 2020, The main objective of this week is to eliminate glaucoma blindness by motivating people to have regular eye check-up including Optic nerve examination.

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Glaucoma is the second most common cause of blindness worldwide. WHO has estimated that 4.5 Million people are blind due to glaucoma. In India, Glaucoma is the leading cause of Irreversibleblindness, with at least 12 million people affected, and nearly 1.2 million people are blind from the disease. More than 90% cases of glaucoma remain undiagnosed in our community due to lack of awareness about this disease.

Glaucoma is a term use to describe group of diseases of the eye, characterized by progressive and irreversible damage to the optic nerve, (nerve of the eye responsible for the vision) and which if untreated, may lead to blindness. One of the important factors is increase in the pressure of the eye but people with normal eye pressure can also develop Glaucoma (NTG).

There are several types of Glaucoma, however the two most common typesin adult population are Primary Open Angle Glaucoma (POAG) which has a slow and insidious onset and Angle Closure Glaucoma (PACG) which is less common and tends to be more acute in presentation .The third common variety is Secondary Glaucoma – where IOP rises secondary to inflammation or trauma or intumescent Cataract causing damage to Optic nerve head leading to a characteristic pattern of visual loss.

The risk factors for development of Glaucoma are:

1.            Age > 60 Years - the prevalence of Glaucoma is seen to increase withAge

2.            Family history of Glaucoma - the first degree relative (FDR) of glaucoma patients show10 fold increase in prevalence ofGlaucoma.

3.            Systemic Diseases-

a.            Diabetes – there is a 5 fold higher risk of developing Glaucoma compared to the restof population.

b.            Hypertension–

c.             Coronary heart disease–

d.            Sickle cell disease–

4.            Nearsightedness (Myopia)

5.            Steroid User’s – more prone to develop Glaucoma when taken by any route of administration (inhalational, Topical ointments, Eyedrops)

6.            History of Blunt injury to theEye

7.            Racial factor : more common in AfroAsians.

The modality of diagnosis of the common forms of glaucoma, would be a combination of 4 tests namely

1.            Recording Intra Ocular Pressure ( by GoldmannApplanation Tonometry)

2.            Gonioscopy ( study of the drainage angle of the eye)

3.            Stereoscopic evaluation of Optic nerve head ( with Aspheric lens +78 D)

4.            Visual field analysis ( perimetry)

All modalities of treatment work by reducing Intra ocular pressure irrespective of the type of Glaucoma which include

1.            Medication (Drops)

2.            LaserTreatment

3.            Glaucoma Surgery (Trabeculectomy)

Take Home Message:

A comprehensive eye examination is recommended for all people above 40 years, especially those with the family history of glaucoma - early diagnosis and treatment can go a long way in preventing blindness fromglaucoma.