About Glaucoma ... A patient perspective



You won't see any obvious sign about glaucoma or failing vision, when you look into the eyes of 62-year-old Sam Fong. His eyes are slightly red from the drops he administers daily, but that is it.

He clutches a book that he is in the middle of reading, and he still drives.

The recently retired civil engineer has lived with glaucoma for seven years. Mr Fong did not realise he had glaucoma because there was no pain or any other symptom. "The eye is a very accommodating instrument and doesn't complain," he said.

He learnt about glaucoma when he had the disease in 1999 after undergoing surgery to remove cataract in his eyes. It was during the follow-up eye examination that he was told he had chronic open-angle glaucoma.

What is Glaucoma?... About gluocoma ...

Glaucoma is not one but a group of conditions in which the optic nerve suffers damage at the back of the eye. This optic-nerve damage causes loss of vision and, in time, blindness. The reason for the optic-nerve damage comes from high pressure. Eye pressure is maintained by the flow of liquid (aqueous humour) within the eye.

In glaucoma, the eye's drainage system becomes clogged so the fluid cannot drain. As the fluid builds up, it causes pressure to build, and damage to the optic nerve occurs.

One unfortunate face about glaucoma is, once diagnosed with the disease, there is no cure, but lowering eye pressure slows progression and can save vision.

There are different types of glaucoma: primary open angle, acute angle closure, chronic angle closure, secondary and congenital.

Open-angled glaucoma is caused by progressive blockage of the drainage channels of the eyeball, accompanied by a slow rise in pressure. This type has no symptoms.

Angle closure can be acute or chronic.

Acute angle closure is the type that usually affects Chinese women. A sudden blockage of fluid results in a rapid rise in pressure. Symptoms are eye pain, headache, vomiting and blurred vision.

Chronic angle closure is like open angle in that it progresses gradually from progressive blockage of the drainage channels, and a prolonged rise in pressure. There are no symptoms.

The chronic version is 10 times more common than the painful acute version. The congenital forms can develop in children, teenagers and young adults, so you can get glaucoma problems at all stages in life.

The over-50s face an increased risk of both open-angled and angle-closure glaucoma.

Secondary glaucoma can be caused by injury to the eyeball. It is relatively rare, but things like wakeboarding, mountain biking, being punched in rugby or in boxing can result in glaucoma.

The problem about glaucoma is that it can be a silent disease. That's why the doctors call it "silent thief of vision" because it steals your vision before you realise it.

The sad fact about glaucoma is that, by the time you have tunnel vision, it's almost what we call end-stage glaucoma where an extensive amount of damage has occurred - 20 per cent or more - and you can just try to stabilise it.

Do not think that if you don't have pain, you don't have glaucoma. People with pain will seek help because it is so severe. It's the silent ones you should worry for because they lose their sight before they know they are in trouble.

Even though any damage to the eye is permanent, the remaining vision can be saved and the disease controlled. Treatment is in the form of eye drops or, depending on severity, surgery to relieve the pressure on the eye.

Tests are carried out every six months on the optic nerve, vision function and eyeball pressure. The cost of eye drops varies from $5 to $40 per bottle.

Glaucoma cannot be prevented, but it can be caught early and damage limited.

Who are prone to glaucoma? ... About Glaucoma ...

Some people are more prone to the disease than others: people who are already myopic, those with a family history of glaucoma, those over 65 years old, those with a previous history of trauma to the eye or long-term use of topical steroid eye drops.

Elderly Chinese women are on the risk list, as are African-Americans and diabetics.

The eye disease has left 4.5 million people in the world blind. According to the World Health Organisation, it accounts for just over 12 per cent of all global blindness.

Glaucoma is a chronic illness. It is analogous to diabetes and hypertension, but those two are well supported and understood. A lot of people don't know what glaucoma is.



Article about glaucoma - A Patient's Perspective Part 2

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