Smoking worsens glaucoma
What is Glaucoma?
Glaucoma is a multifactorial disease or an end stage of a group of diseases with characteristics of optic nerve changes, visual field defects with intraocular as the only modifiable risk factor.
It is the commonest cause of irreversible blindness and the third biggest cause of blindness worldwide. Glaucoma affects around 60 million people in both developed and developing countries.
According to the Nigerian National Blindness and Visual Impairment Survey carried out between 2005 and 2007, glaucoma contributed 16.7 per cent to the magnitude of blindness.
What are its symptoms?
The symptoms of glaucoma are dependent on the stage and classification of the condition. It could range from no symptoms, blurry or foggy vision, poor vision, bumping into objects, tripping over objects, poor peripheral (side) vision to the inability to perform basic tasks in cloudy weather or in the rain e.g. driving or total visual loss (blindness). In the angle closure type, there is severe pain, redness, seeing of colours around lights (haloes), nausea and/ or vomiting. This is an emergency if it occurs.
Can it be treated?
Yes, it can be treated. The goal of treatment is to preserve visual function and quality of life. There are various forms of treatment or management. It is worthy of note that currently there is still no cure for glaucoma. So early detection and prompt treatment is the key to preservation of this avoidable cause of blindness. Treatment can be medical (use of various types of eye drops) and surgical (manual and laser). The choice of the type of treatment is individualised with various consideration before taking a decision on the treatment strategy. Treatment varies from children to adults.
What ages are prone to glaucoma?
All ages are affected. One can be born with it glaucoma (congenital), age 1 to 3 years (infantile), 3 to 16 years (juvenile) and greater than 40 years (open or close angle glaucoma).
How is it detected?
To detect glaucoma, one needs to go for eye check to be done by a glaucomatologist (an ophthalmic subspecialist) or a general ophthalmologist who will conduct series of examinations and tests depending on what is detected to confirm the diagnosis of glaucoma. This include but not limited to checking of intraocular (eye) pressure, gonioscopy, optic nerve head assessment, visual field test and some other imaging tests as required and if necessary.
Can one develop glaucoma without any increase in the eye pressure?
Yes, it is possible for one to develop glaucoma without increase in the eye pressure. This variant of the disease is called normal pressure glaucoma in which the intraocular pressure is within normal limits (10–21 mmHg) after due consideration of the corneal thickness and contours. The risk factor for this variant includes systemic hypotension, vascular (blood) sufficiency and low corneal thickness among others. It has been found to be common in females and more frequent in Japan than Europe or North America as reported in some studies.
Is glaucoma hereditary?
Yes, glaucoma can be hereditary. The role of genetics in the development of glaucoma cannot be overemphasised so much so that close blood relations of patient with glaucoma are at greater risk of developing the eye condition. Some genes have been identified to be responsible for various forms of glaucoma and future therapy is targeted at modification of these genes.
Is it true that smoking is good for person with glaucoma?
Is there anything that smoking is good for? The answer is no. In fact, smoking and the specific substance smoked worsens glaucoma.
Why is glaucoma referred to as ‘silent thief’ of sight?
Glaucoma is called a ‘silent thief’ of sight because it often develops without any obvious symptom or signs at the early stage until later stage when one begins to notice any of the symptoms earlier mentioned or detected by routine examination. By the time the symptoms become noticeable, about 40 per cent (400,000 – 500,000) of the 1.2 million of the nerve fibres are already lost. With 75 per cent loss (800,000) patients becomes aware of poor peripheral (side) vision.
Are there harmful practices on the eye likely to trigger glaucoma?
Yes, there are several other causes leading to what is called secondary glaucoma. These include therapeutic or habitual use of self-medication that may affect the anterior chamber angle, cause inflammation or affect the dynamics of the intraocular fluid e.g intraocular surgeries, use of some eye drops among other harmful traditional practices.
Is there enough awareness on the eye condition?
Awareness has improved and has been on the increase. That is why we have the World Glaucoma Week to keep up with information dissemination to Beat Invisible Glaucoma (BIG). Honestly, if only people can be aware of glaucoma the way we all became aware of the Ebola Virus Disease, eye specialists will be extremely happy. I must add that there is still need for more awareness on glaucoma in order to detect it early.
How can it be avoided?
Glaucoma blindness can be avoided through early detection following screening by a glaucomatologist or general ophthalmologist so that prompt and early treatment or management can be instituted. This is the goal of the vision 2020 which is a global initiative to eliminate avoidable blindness by year 2020.
What is the percentage of sufferers of the eye condition in Nigeria?
Earlier, I mentioned the magnitude of glaucoma blindness in Nigeria. It is important to note that the prevalence of glaucoma blindness is 0.7 per cent in Nigerian population over 40 years. The condition itself affects 3.6 per cent of population above 40 years. Blindness from glaucoma is 10 times higher in developing world. The clinical course in blacks runs an aggressive pattern as reported in a study conducted by Kosoko et al.
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