Job Osazuwa
The eye is apparently like a camera for everyone. It is one of the sense organs that no one jokes with. It is a sensitive organ that many parts of the body rely on in order to function effectively.
It will interest you to know that over 70 per cent of the brain’s processing power is devoted to eyesight.
Glaucoma is one of the problems associating with the eye, which causes blurry vision and might result to total blindness if not detected and treated on time.
Experts have described glaucoma as a condition that damages one’s eye’s optic nerve. It gets worse over time. It is often linked to a build-up of pressure inside your eye. Glaucoma tends to run in families. One usually doesn’t get it until later in life.
However, there is also infant or congenital glaucoma – meaning one is born with it. It is usually treated with surgery because the cause is a problem with your drainage system.
The increased pressure in one’s eye, called intraocular pressure, can damage your optic nerve, which sends images to your brain. If the damage worsens, glaucoma can cause permanent vision loss or even total blindness within a few years.
A consultant ophthalmologist, ophthalmic surgeon and vitreoretinal specialist at the Eye Foundation Hospital and Eye Foundation Retina Institute, Ndubuisi Nkonkwo said that Nigerians need to take their health and eyes in their own hands.
While discussing the importance of taking care of the eye, recently on a national television programme, he said that over the years, he has discovered that most Nigerians handle the issues of their health, including the eye with levity. He said that each person’s eye health is his or her responsibility, including taking care of the eyes.
According to him, there was a study that revealed the average duration of time patients present to the hospital to seek help to be about 22 months. He stated that the study implies that the patients’ eyes symptoms must have started almost two years before seeking medical help. He said that the finding was way beyond what is expected from a society like Nigeria. He pointed out that there were different health seeking behaviours that Nigerians display that are completely wrong, which he advised must be changed.
Describing the anatomy of the eye, he said: “When you talk about the eyes, you wonder about the architecture of the eyes; it is so magnificent. The retinal is like the film of the eyes, which capture the image. It has blood vessel and performs a lot of work. The cornea and the lens give the power that bends the ray of light to fall on the retinal, and it goes on and on until the image gets to the brain and gets interpreted.
“Glaucoma is the silent thief of sight because there is often time no symptoms. Glaucoma damages the optic nerve fibres. The pressure within the eye might be high but at some other times, it might not be high.
“It is important to see your doctor every year even if you don’t have eye problem. Glaucoma is devastating because it is the commonest cause of irreversible blindness. It is more aggressive in black that is why we must be alert. If you don’t have it this year, it doesn’t mean that you will not have it next year. From age 35, start going for regular eye check.”
Unthinkable things people do to cure eye problems
Nkonkwo revealed: “What we have is that when Nigerians have eyes problem, they run to the pharmacists. I have heard a situation whereby a patient had red eye and was advised to apply urine drop in her eye. This is completely wrong. The urine can be contaminated with infections such as gonorrhoea, staphylococcus and others. When applied into the eyes, it can cause fulminating infection. In the process, the cornea could be adversely affected.
“I have seen patients who used water from the battery. It is outrageous what people can put into their eyes. Whereas, the right eye drop could have solved the problem if ophthalmologist was consulted. The decision lies with you to take the right step about the health of your eyes.
Eye safety tips
The specialist advised: “I must emphasise the importance of lubricating the eyes especially as these days we have a lot of dryness, reddish and itching of the eyes as a result of many factors. Now we spend long hours on our telephones and computers. In those days, the light comes on the book and then from the book to your eyes. But now it goes directly into your eyes. So, we advise people to get glasses to protect their eyes from the rays that come from the phones and computers. There is need to blink often so that the eyes get moisturised. There are also lubricant eye drop to solve the problem. The best tears supplements are the ones that are preservative free.”
Most people with glaucoma have no early symptoms or pain. Visit your eye doctor regularly so they can diagnose and treat glaucoma before you have long-term vision loss.
If you lose vision, it can’t be brought back. But lowering eye pressure can help you keep the sight you have. Most people with glaucoma who follow their treatment plan and have regular eye screenings and are able to keep their vision.
Glaucoma causes
The fluid inside your eye, called aqueous humor, usually flows out of your eye through a mesh-like channel.
If this channel gets blocked, the liquid builds up. Sometimes, experts don’t know what causes this blockage. But it can be inherited, meaning it’s passed from parents to children.
Less-common causes of glaucoma include a blunt or chemical injury to your eye, severe eye infection, blocked blood vessels inside your eye, and inflammatory conditions. It’s rare, but eye surgery to correct another condition can sometimes bring it on. It usually affects both eyes, but it may be worse in one than the other.
Risk factors
It mostly affects adults over 40, but young adults, children, and even infants can have it. Africans tend to get it more often, when they are younger, and with more vision loss. You are also more likely to get it if you:
Are over 40; have a family history of glaucoma; have poor vision and suffering from diabetes.
Others are people who take certain steroid medications such as prednisone; those who had an injury to your eye or eyes; corneas that are thinner than usual; those with high blood pressure; heart disease; sickle cell anaemia; high eye pressure and nearsighted or farsighted people.
Types of glaucoma
There are two main kinds: Open-angle glaucoma. This is the most common type. Your doctor may also call it wide-angle glaucoma. The drain structure in your eye (called the trabecular meshwork) looks fine, but fluid doesn’t flow out like it should.
While angle-closure glaucoma is said to be more common in Asia. One may also hear it called acute or chronic angle-closure or narrow-angle glaucoma. One eye doesn’t drain like it should because the drain space between your iris and cornea becomes too narrow. This can cause a sudden build-up of pressure in the eye. It’s also linked to farsightedness and cataracts, a clouding of the lens inside your eye.
Less common types of glaucoma include: Secondary glaucoma. This is when another condition, like cataracts or diabetes, causes added pressure in your eye.
In normal-tension glaucoma, the patient has blind spots in your vision or your optic nerve is damaged even though your eye pressure is within the average range. Some experts say it’s a form of open-angle glaucoma.
With Pigmentary glaucoma, tiny bits of pigment from your iris, the coloured part of your eye, get into the fluid inside your eye and clog the drainage canals.
Glaucoma Symptoms
Most people with open-angle glaucoma don’t have symptoms. If symptoms do develop, it’s usually late in the disease. That’s why glaucoma is often called the “sneak thief of vision.” The main sign is usually a loss of side, or peripheral, vision. On the other hand, symptoms of angle-closure glaucoma usually come on faster and are more obvious. Damage can happen quickly.
Experts have advised that if anyone has any of these symptoms, he or she should quickly seek medical help: Seeing halos around lights; vision loss; redness in your eye; eye that looks hazy (particularly in infants); upset stomach or vomiting and eye pain.
Glaucoma diagnosis
Glaucoma tests are painless and don’t take long. Your eye doctor will test your vision. They’ll use drops to widen (dilate) your pupils and examine your eyes.
They will check your optic nerve for signs of glaucoma. They may take photographs so they can spot changes at your next visit. They will do a test called tonometry to check your eye pressure. They may also do a visual field test to see if you’ve lost peripheral vision.
Glaucoma treatment
Nkonkwo who is the Director of Training for the Prevention of Blindness at the institute said: “Then talking of cataract, the surgery is the commonest surgery done worldwide. As population ages, cataract comes. It develops as a result of aging. There could be cataract in new born babies as a result of lack of certain hormones or enzymes and other infections. There could be blurriness of the lens.
“This type of surgery has advanced so much these days and can be dealt very well now. The way it done now is that you remove the lens and replace it with something else that is as good as the lens – intraocular implant. And these implants stay for life. Patients don’t need to change them.
“Unfortunately, we are going back to the era where we see a lot of quackery. We have situations whereby some of patients come to the clinic, but before then, they have undergone ancient process called couching. This is a pre-medieval way of doing cataract surgery whereby the lens is pushed into the back of the eye. Many of the patients are deceived into having this because they are told that it will cost less and that it will be done in their houses.
These people are by no means doctors; they must have learned the trade from their fathers.
“When the procedure doesn’t go well, the lens comes to the front and it damages the cornea and the nerves. We must do everything to stop this practice because it is archaic. Most of the patients who do this, their eyes are ruined forever.”
In addition, your doctor may use prescription eye drops, oral medications, laser surgery, or microsurgery to lower pressure in your eye.
Eye drops either lower the creation of fluid in the eye or increase its flow out, lowering eye pressure. Side effects include allergies, redness, stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect your heart and lungs. Be sure to tell your doctor about any other medications you’re taking or are allergic to.
The doctor might also prescribe medication for the patient to take by mouth, such as a beta-blocker or a carbonic anhydrase inhibitor. These drugs can improve drainage or slow the creation of fluid in your eye.
Laser surgery: This procedure can slightly raise the flow of fluid from your eye if you have open-angle glaucoma. It can stop fluid blockage if you have angle-closure glaucoma. Procedures include: Trabeculoplasty. This opens the drainage area.
Iridotomy: This makes a tiny hole in your iris to let fluid flow more freely.
Cyclophotocoagulation treats areas of the middle layer of your eye to lower fluid production.
Microsurgery is a procedure called a trabeculectomy, your doctor creates a new channel to drain the fluid and ease eye pressure. This form of surgery may need to be done more than once. Your doctor might implant a tube to help drain fluid. This surgery can cause temporary or permanent vision loss, as well as bleeding or infection.
Open-angle glaucoma is most often treated with combinations of eye drops, laser trabeculoplasty, and microsurgery. Doctors tend to start with medications, but early laser surgery or microsurgery could work better for some people.
Glaucoma prevention
Experts have said that glaucoma cannot be prevented. But they enlightened that if one finds it early, one can lower his or her risk of eye damage. These steps may help protect your vision:
Have regular eye examinations: The sooner your doctor spots the signs of glaucoma, the sooner you can start treatment. If you’re over age 40 and have a family history of the disease, get a complete eye exam from an eye doctor every 1 to 2 years.
If you have health problems like diabetes or are at risk of other eye diseases, you may need to go more often.
Learn your family history: Ask your relatives whether any of them have been diagnosed with glaucoma. Follow your doctor’s instructions. If they find that you have high eye pressure, they might give you eye drops to prevent glaucoma.
Routine exercise: Moderate activity like walking or jogging at least three times a week might help lower eye pressure.
Protect your eyes: Use protective eyewear when playing sports or working on home improvement projects.