By VIVIAN ONYEBUKWA and HENRY OKONKWO
At 13, children are known to be boisterous, exuberant and full of life. Sadly, it was at this age that Solomon Mishack lost his sight to glaucoma. He, at that young age, was sentenced to permanent blindness all through the rest of his life. No one can appreciate Solomon’s plight of having his sight blighted. Indeed, no one, except the sufferers can explain the sadness and bitterness glaucoma brings when it renders them visually impaired.
Glaucoma is one of the leading causes of irreversible blindness in the world. This condition, often referred to as the silent thief of sight, indeed creeps in like a thief in the night and snatches sight away from its unsuspecting victims – silently and painlessly. The disease causes progressive damage to a person’s vision, and only becomes apparent much later, often when it has become rather late.
Although glaucoma is believed to affect adults around the age range of 35-40 years, it has been proven that babies, toddlers, teens and young adults in their 20s can get glaucoma as well. This means the young would live most of their lives coping with the disease. And if not diagnosed and treated early enough, glaucoma may lead to vision loss.
Diagnosing glaucoma:
According to Dr. Ejokhaye Uujamhan of Twenty-Twenty Eye Centre, Lagos, glaucoma does not give any signs or symptoms in its initial stage. “It is after a test that you can discover. When the doctor looks at the back of the eye, to see the blood vessels and other things, that is the baseline of action. Other things would now prompt us to do other diagnostic tests that would confirm it.
Another eye physician, Dr. Adedayo Olympio-Director, also of Twenty-Twenty Eye Centre, Ikeja, Lagos discloses that glaucoma is a build up pressure, if there is no proper drainage in the eye. “I would like to liken it to water fountain. If the one that is supposed to go out is not going out, it builds up pressure. It occurs when there is improper drainage of fluid in the eye. that leads to pressure.”
How Glaucoma steals sights:
According to optometrists, the journey to blindness via glaucoma is often stealthy. “Many patients often relate a history of a slowly progressing, painless visual deterioration which they largely ignored or casually managed by using reading glasses”, Dr. Ijeoma Obima says. She explains that patients with glaucoma typically lose their peripheral vision first and then, usually only much later, their central vision.
“This means that they only notice that there is a problem with their vision at an advanced stage of the condition, normally when they realise that they are unable to see things approaching them”.
Dr. Obima says that another common scenario is that of a patient who, when covering one eye, notices that he can see markedly better with one eye than with the other. She explains that although there are cases where glaucoma affects only one eye while the other continues to function normally, “it is far more common for these patients to suffer from a type of glaucoma known as open-angle glaucoma, where both eyes are affected, but the speed of progression of the disease is not the same in both eyes.”
She adds: “Primary open-angle glaucoma is common among us Africans and is also prevalent among diabetics, myopic (short-sighted) individuals and patients who suffer from diseases of the heart and blood vessels.
Glaucoma can be hereditary, it may also arise as a complication of many other conditions, such as blunt-instrument injuries to the eyes or various inflammations, infections and tumours.
Chief Cajethan Amadi’s own ordeal towards being blind all started when he was an employee in a restaurant. He was pounding fufu with vigour and mistakenly raised the mortar into his eye. The pain was excruciating, so he went get some treatment. He first went to University of Nigeria Teaching Hospital, Enugu (UNTH) where he was given some eye drops. But in his quest to seek faster and total cure he went to a herbalist who poured hot herbal concoctions into his eyes. At a point he noticed that his two eyes began to dim. “I went to an Indian doctor who warned me that I’m at the verge of becoming a blind man. I realized this on a day, I went to visit a friend in Festac. When I wanted to leave, I stumbled on objects. I noticed I didn’t seem to see things around me. However, it was on December 8, 2005 that my sight packed up after an eye operation in one of the hospitals in Lagos.”
Worrisome statistics:
In a national survey for blindness, about 16 per cent of the population has glaucoma. Again during this year’s World Glaucoma Week in March, the South East region was adjudged to have the highest prevalence of glaucoma in Nigeria.
“Glaucoma is worse among black Africans, and in Nigeria, the most populous black nation, we have a high incidence of glaucoma. And according to the last national survey on the population of glaucoma patients, South East has the highest prevalence of glaucoma blindness in Nigeria. It is uncertain yet why that is so and we are doing research to find that. There are no known causes yet,” declares Dr. Nkiru Kizor-Akaraiwe Chief Consultant Ophthalmologist at The Eye Specialists Hospital (TESH) Enugu State.
And it is because of these worrisome statistics that Thursday, last week was marked the ‘World Sight Day’- an annual event to raise awareness on blindness and visual impairment.
Socio-economic implications:
The socio-economic implications of irreversible blindness are enormous and negatively impact family units, standards of living and the economy as a whole. the cost of eye drops to manage infections like glaucoma could be quite a huge challenge to most Nigerian families. A small pack of Cosopt and Pillocarpine,- eyedrops used by glaucoma patients are sold for as much as N5, 000 and N3, 500 respectively.
Ophthalmologists have called on the Federal Government to ease the duties and taxes on drugs for the treatment of eye conditions, especially glaucoma, which is a life long ailment.
Arresting glaucoma:
Overtime local and international eye healthcare professionals have continuously committed their time and knowledge to raising awareness of and demystifying this terrible condition.
While treatment is effective in halting the disease, it cannot reverse damage already done to sight. And this means that the sooner it is diagnosed, the less damage is done and the more vision there is to save.
Treatment can be either medical, with the use of eye drops and/or tablets, or surgical. Treatment options are usually determined by the treating ophthalmologist after careful assessment.
“If we look at it, blindness from glaucoma is something we can prevent; glaucoma if detected early and if the treatment is started early will not necessarily cause blindness throughout the individual’s life. So, it is important that the individuals check their eyes because it is a silent disease. Everybody should check their eyes at least once a year. For people with a family history, at least twice a year, because it is only by going for full eye examination that one can detect if there is glaucoma or not,” said Dr. Adunola Ogunro a Consultant Ophthalmologist at the Eye Foundation Hospital, Apo, Abuja.
Cheery news:
Amid all the gloomy and precarious situation, medical experts believe that there are a lot to cheer about on the level of glaucoma awareness among Nigerians.
“In Glaucoma, we talk of management than cure. But in the recent past, management has been made easier, because of better pressure lowering drugs,” said Dr. Olympio.
Also Dr. Gloria Okehkian notes: “The first thing is awareness, for people to know. during the World Glaucoma Day, we went all out to create awareness. We have a lot of media programmes. It comes in March every year. We also have Glaucoma screening during the week.”
However, Dr. Olympio called for more awareness to be targeted at those in the rural areas. “NGO’s should help by going to the rural areas where people and their children are losing their sight every day. They don’t need to come to the city. They should also work with eye care professionals.”