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Glaucoma, the ‘silent thief of sight’, is a disease that affects the optic nerve which connects the eye to the brain. Similar to nerves in other parts of the body, damage almost always result in loss of function that is irreversible. The same applies to the optic nerve.
Glaucoma is the leading cause of irreversible blindness worldwide. According to the Nigerian National Blindness Survey done between 2005-2007, glaucoma is the second most common cause of blindness affecting 16.7% with a prevalence of 0.7% and the most common cause of irreversible blindness.
A more global picture is given by a systematic review and meta-analysis done by Yih-Chung Tham and colleagues and published in the American Academy of Ophthalmology journal 2014, ‘Global Prevalence of Glaucoma and Projections of Glaucoma burden through 2040’. According to the review, in 2013, the number of people (aged 40–80 years) with glaucoma worldwide was estimated to be 64.3 million, increasing to 76.0 million in 2020 and 111.8 million in 2040.
Thus, the number of people with glaucoma worldwide will increase to 111.8 million in 2040, disproportionately affecting people residing in Asia and Africa. These estimates are important in guiding the designs of glaucoma screening, treatment and related public health strategies.
The projected figures are quite alarming and lay emphasis on the public heath significance of this disease. Glaucoma causes irreversible nerve damage. It is usually a slowly progressive disease especially the type common in people of African descent, Primary Open Angle Glaucoma, going on unnoticed by the patient.
As such, early detection and treatment is the key to preventing blindness.
The cause of glaucoma remains yet unknown but some risk factors have been identified such that presence of these factors increases the need for routine eye examination. Risk factors include elevated intraocular pressure, increasing age, and African descent, family history of glaucoma, vasospasm, low blood pressure and high myopia.
Several advances in glaucoma diagnosis now include the phenomenon of pre-parametric diagnosis of glaucoma, picking changes in structure before it begins to affect function. In other words, the detection of the disease before it begins to affect vision.
The role of screening cannot be over emphasized, so everyone who has an identifiable risk factor and even people without should have their eyes screened from time to time. Everyone over the age of forty should have an eye examination annually and this should be done earlier in the presence of risk factors. The eye doctor-ophthalmologist will then advise if further testing will be required. Earlier diagnosis and treatment will reduce visual disability, improve patient quality of life and decrease overall cost of treatment. Treatment is mainly tailored towards lowering of intraocular pressure through the use of medications, laser treatment and sometimes surgery.
The glaucoma week is a week set aside for glaucoma annually. It is a global initiative aimed at raising awareness for glaucoma. It was first observed on 6th march 2008 and this year will hold between 11-17th of March 2018.
Several eye clinics in Nigeria, Skipper Eye-Q included, offer free eye screening services during this week in a bid to encourage people to get their eyes tested. Go get your eyes tested, tell your neighbour to get his/her eyes tested and together lets ‘Beat Invisible Glaucoma’. GREEN- Go get your eye tested for Glaucoma, Save Your sight!
Temitope Tijani
Dr Tijani MBChB, FMCOph, is Consultant Ophthalmic Surgeon, Medical Director Skipper Eye-Q Super specialty Hospitals
