Glaucoma – A STEALTH DISEASE
Glaucoma is an optic nerve condition that doesn’t directly damage the retina but robs many people of vision. Fluid flows into and drains out of the eye at set rates. When it doesn’t flow quickly enough, pressure can build up, damageing the optic nerve. This causes irreversible peripheral vision loss and can lead to blindness.
You can’t tell if you have glaucoma because it’s painless, your central vision is intact, and you’re tricked into believing that you have peripheral vision.
Unlike AMD, it’s not a dark spot. For example, you are behind three cars but you see two cars. What do you see instead of the third car? You just see street. Your brain fills in what you expect to see or are used to seeing. If a child runs into the street and into the part where you don’t see anything, you don’t even notice that you don’t see the child.
The World Health Organization cites glaucoma as the second leading cause of blindness in the world. Glaucoma is more common after age 60 and it often runs in families. There’s no way to lower your risk and no cure, but there are treatments – eyedrops are most common, followed by laser treatment or surgery.
Although drops can prevent vision loss, unfortunately many patients don’t consistently use their drops. Doctors want to change this. Moorfields Eye Hospital in the UK is currently leading a large, randomised, multi-centre trial of people with glaucoma to see which is the most cost-effective treatment and which one patients prefer, the drops or the laser treatment.
Peter Austin was diagnosed with early glaucoma at age 32. At 61, his vision is still intact because, twice a day, he applies eyedrops.
“It’s not uncomfortable, it’s not difficult – you just have to be disciplined,” said Austin, a patient advocate with the International Glaucoma Association. “Tell me, how much of your eyesight would you like to lose before you felt terrible enough to do something? I haven’t missed a dose for more than 20 years.”
loss, in most of the cases, if it is diagnosed early and treated.”
Proliferative diabetic retinopathy is usually treated with laser surgery to reduce bleeding at the back of the eye. A separate condition, called diabetic macular oedema (DME), is developed by about half of those with diabetic retinopathy. DME is treated with regularly scheduled anti-VEGF intra-ocular injections, which block a protein that can stimulate abnormal blood vessels to grow and leak fluid.
Retinal detachment is a medical emergency and is more common after age 40. It’s often caused by the ageing process.
The interior of the eye is filled with a gel-like substance, the vitreous. As you get older, the vitreous can shrink, and it may pull on the retina as it shifts. Sometimes, it pulls with enough force to tear the retina, separating it from the back of the eye so that the retina can’t work properly.
Ophthalmologists can easily identify a detached retina. Reattaching it quickly can restore vision.
Although it is complex and difficult surgery, surgeons get good results.
In 2014, Tom Greenberg had no idea that he had a detached retina.
“I started seeing a dark blob on the edge of my field of vision, and it would move around some as I moved my eyes,” says Greenberg, now in his late 60s.
He waited a week before seeking help. Although a surgeon reattached his retina, vision in that eye remains distorted. When his other eye exhibited identical symptoms in 2017, Greenberg acted quickly – he had surgery that day, and the vision in that eye is as good as it was before.
Lifestyle changes can’t prevent age-related retinal detachment, but you can preserve your sight by getting treated promptly.