Poor awareness makes glcoma extremely dangerous condition with potential to cause irreversible visual impairment!

Poor awareness makes glcoma extremely dangerous condition with potential to cause irreversible visual impairment!
(L-R) Dr G Chandra Sekhar, Vice Chair; Dr Sirisha Senthil, Head, Glaucoma Services & Dr Siddharth Dixit, Glaucoma Specialist, L. V. Prasad Eye Institute; with a poster on World Glaucoma Week, starting from March 10th to 16th 2019, at a press conference, today, at L. V. Prasad Eye Institute. Glaucoma, a disease of the optic nerve is the leading cause of irreversible blindness in India. Since there are no warning signs, it is referred to as the ‘sneak thief of sight.’

Hyderabad, March , 2019: L V Prasad Eye Institute (LVPEI) plans a series of activities to commemorate World Glaucoma Week, from March 10 -16, 2019, to bring public focus on the eye disease that affects both adults and children. A Glaucoma Awareness Walk is being organised on March 10 to raise awareness and knowledge on Glaucoma, which is seen as the leading cause of irreversible blindness in India. Also on agenda there is a Glaucoma Education Forum on March 15 to educate the public on the need for periodic eye check-up and the harmful effects of prolonged steroid use.

“As the leading cause of irreversible blindness and a major cause of vision impairment, glaucoma care and delivery need to be a part of our strategies to deliver universal health coverage. Poor patient awareness makes glaucoma an extremely dangerous condition with high potential for causing irreversible visual impairment in millions of patients. Prevention and early treatment of glaucoma are key aspects in combating this disease,” said Dr Sirisha Senthil, Head of Glaucoma service, L V Prasad Eye Institute. She said, the focus of this year’s awareness is Children and over use of medication and family with history of Glaucoma being at high risk and all the family members should get screened for glaucoma annually to prevent them from getting glaucoma and going blind. Having glaucoma is fine but not detecting in time or treating is the problem. Even those with an injury or ones with myopia or high minus power are at high risk of glaucoma and they need to undergo check up routinely. We should be careful of any form of steroids, even skim creams, asthma puffs or any other medication in the form of tablets which are unmonitored, can be sometimes harmful and lead to glaucoma.

Poor awareness makes glcoma extremely dangerous condition with potential to cause irreversible visual impairment!

Dr G Chandra Sekhar, Vice Chair, L V Prasad Eye Institute; said, most people aren’t aware of glaucoma, even when the professional wants to do a complete eye check up, we are happy to check our eye sight and try and avoid comprehensive eye check up. But if we become aware that there is blinding disease of the eye known as  Glaucoma, than we may become extra cautious and undergo complete check up, that helps to detect early and get treated. Across the world including in developed countries 50% of those with glaucoma don’t know they have glaucoma and in Indian context 90% of those with glaucoma may not be aware that they have glaucoma. The second paradox is 50% of the people who have glaucoma, have seen an eye care professional in the last two years but their disease hasn’t been picked up, either because the examination was not complete or because they were in a hurry and didn’t allow complete examination to be done. 50% of the people who were told they have glaucoma and needed treatment, were not compliant with the treatment.

Dr Siddharth Dixit, Glaucoma Specialist, L V Prasad Eye Institute; said, Glaucoma is the leading cause for irreversible blindness in the world. For something like cataract or other eye ailments, vision can come back, but with glaucoma, no scope to get back vision. A complete check up of the eye can enable detection of glaucoma at an early stage. The awareness about glaucoma being a blinding disease is rising and the positive thing is you can detect glaucoma very very early and remain symptom free throughout, the awareness about this too should spread. But what is of serious concern is small children getting glaucoma, unfortunately the kind of drops, syrups and drugs available over the counter in India is completely unregulated. Many times people in rural areas take medication and injections without doctor’s prescription, mostly on the recommendation of a pharmacist, sometimes even from untrained persons in pharmacy. These people know steroids work like magic and is commonly prescribed, especially for eye irritation, but they can cause irreversible damage in little children. Any child with redness in eye, allergy should get a complete eye monitoring and should not use these wonder drugs available across the counter. We should call for strong regulations by the government, they should bring in strict regulations to prevent sale of these kind of drugs over the counter.

In India, 12 million people are affected accounting for 12.8% of the blindness. High rates of blindness in India are due to undiagnosed glaucoma. Estimates suggest that nearly 80 million people will be living with some form of glaucoma by 2020. Many people with glaucoma are not diagnosed until they start turning blind. Glaucoma is a complex condition and refers to a group of conditions that result in optic nerve damage and visual field loss. High intraocular pressure is a “risk factor” for glaucoma, together with other factors such as ethnicity, family history, high myopia and age.

Glaucoma is the major cause of irreversible blindness around the world, and the numbers are projected to increase exponentially in both the developed and developing world.  Research and new innovative approaches from rapid assessment to novel therapies will be required to prevent unnecessary blindness from glaucoma worldwide in the next few decades. In its most prevalent form – primary open angle glaucoma – vision loss is silent, slow, and progressive. It typically affects side vision first (peripheral vision) and as it progresses, central vision is lost. Eye injuries can result in traumatic glaucoma or secondary glaucoma, so protecting your eyes from injury is another way to prevent glaucoma.

According to researchers at Johns Hopkins, the lack of knowledge about glaucoma risk factors, including heredity, stems from lack of patient education. In India, there are about 11.2 million people aged 40 years or older who are afflicted with glaucoma and 1.1 million are blind. Every eighth individual or nearly 40 million of the estimated 309 million population, aged 40 years or older in India, either has glaucoma or is at risk of developing the disease.  The rate of undiagnosed glaucoma cases in India, is 90% in contrast to 40% to 60% in the developed world. Most of these patients present to the ophthalmologist either when they are visually disabled or permanently blind from the disease.

According to Andhra Pradesh Eye Disease Study (APEDS) childhood glaucoma occurs one in 3300 live births. It is more common in children born of consanguineous marriages. Most cases of pediatric glaucoma are diagnosed before the age of six months, with 80% diagnosed by the first year of life. It is crucial to recognise symptoms like enlarged or cloudy eyes, redness, often watering, tending to close the eyes in the presence of light, etc. Early diagnosis is important because secondary problems like myopia and amblyopia also can cause decreased vision.

Steroids are the important treatment for a variety of illnesses that involve inflammation in the body. Although these medications may be necessary in the treatment of the disease, their indiscriminate and long-term use can result in steroid-induced glaucoma. Steroid-induced glaucoma occurs due to rise in the intraocular pressure with steroid administration. This high intraocular pressure can occur within a week or can be delayed for months or years after steroid application. About 5% of the general population is “steroid responder”, i.e., may develop steroid induced glaucoma when steroids are administered. It eventually results in damage to optic (eye) nerve. Glaucoma is a progressive condition, if left untreated it can progress rapidly and may lead to blindness.