Glau­coma – A STEALTH DIS­EASE

Reader's Digest Asia Pacific - - Health -

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.

DE­TACHED RETINA

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.

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