Glaucoma is difficult to detect but it is easy to lose sight
A “silent thief”, namely Glaucoma, may steal away our eye sights if we do not take care our eyes properly and continuously.
Among five senses, vision is the top priority. Loss of sight or impaired vision, life is bound to face a lot of inconveniences. In general, many people only check their eyes when they are either short-sighted or far-sighted. Very often, it would be rather too late to wait until glaucoma start affecting their visions and only seeking medical treatment then.
Glaucoma is the main cause of irreversible blindness, and it is ranked in second position globally, in terms of frequency of causing blindness. At present, approximately 60 to 70 million people in the world are afflicted by glaucoma, and the number is likely to increase to 80 million by 2020. It is expected to make 11.2 million people suffer blindness eventually.
Dr. Lee Ming Yueh, an ophthalmologist and glaucoma specialist, found that the number of diagnosed glaucoma patients is increasing day by day. She pointed out that humans are looking at things with their pair of eyes. When the vision of one eye is damaged, the other eye would start to help.
“In almost every society, more than 50% of people do not know that they have suffered glaucoma. It was not until they conduct visual field test and confirm the presence of glaucoma.
Glaucoma usually occurs in people over 40 years of age with high intraocular pressure.
Dr. Lee Ming Yueh added, if there is a family history of glaucoma, the chances of suffering from glaucoma will be 4 to 10 times higher than the average people. In addition, deep hyperopia is more likely to have acute glaucoma; and deep myopia is more likely to have chronic glaucoma.
“Glaucoma has nothing to do with your IQ. No matter how clever you are, you may suffer from glaucoma. When the visual field is slowly diminished, the patient does not feel it, whereby his vision field continues to shrink, he only realizes that 90% of his vision has been damaged when view starts blurring.”
She mentioned that because chronic glaucoma rarely causes pain, the patient will delay seeking medical treatment; in contrast, acute glaucoma is coming rather quickly. When the patient has symptoms like red and painful eyes or unable to see, he will seek medical advice immediately.
“In the afternoon, our pupils are expanded and squeezed into the drainage area. If there are cataracts, coupled with pupil expansion at dusk, it usually triggers acute glaucoma. Therefore, patients are often seeking medical advice in the afternoon or evening and requiring laser treatment then. If eye pressure exceeds 50 mmHg, patient may go completely blind within a few hours.”
Should not use eye drops with steroids frequently
Another type of glaucoma is secondary in nature, which are related to cataract surgery, diabetes, eye inflammation, sports injuries, or retinal detachment.
Dr. Lee had diagnosed many young patients with glaucoma who were about 20-30 years old. The main cause was eye itchiness. However, these patients purchased and used eye drops with steroids without consulting doctors. They eventually developed glaucoma after long-term use of eye drops with steroids.
“After providing eye drops with steroids, doctors will monitor the situation after use. This is a short-term use. Many people do not notice that long-term use will affect the visual field, when the visual field is reduced, 90% is damaged, and vision becomes blur, it is already late.”
Dr. Lee Ming Yueh also mentioned paediatric glaucoma when she was interviewed. When she was studying at the Moorfields Eye Hospital in the UK, she had come across glaucoma that afflicting children, of which such glaucoma also divided into primary and secondary types.
Children may also have glaucoma
She pointed out that children still cannot express themselves after they are born, so it is difficult to find that they have problems with blurred vision. However, due to the abnormality of eye’s drainage area, an eyeball can grow bigger and bigger, and end up looking like a bull’s eye.
“Cases related to children are more complicated, and surgery is more difficult. Therefore, parents should pay attention to the child’s eyes. Children with glaucoma have opaque eyes and aren’t shining. Besides that, they will always shed tears and avoid light.”
Patients love to ask Dr. Lee Ming Yueh: What can I eat to avoid glaucoma?
She admitted frankly that genes are the main cause of glaucoma. As such, even if you pay attention to your diet, it will not change your risk profile. However, she believes that everyone should insist on eating more fruits and vegetables, exercise, avoid smoking and alcohol, has enough sleep to allow the body gets good rest.
“It’s best to avoid certain movements, such as yoga head down posture (head down), it may cause glaucoma. Because when your head goes down, your intraocular pressure will rise. I also have a patient who is proficient in yoga and suffered from serious glaucoma, and only stabilised after a surgery.”
Surgery can keep eyes of glaucoma patient
For glaucoma, Dr. Lee Ming Yueh will first provide medical treatment, including the use of eye drops; however, if the situation worsens, surgery may become a necessary option. Normally, Trabeculectomy and Glaucoma Tube Shunt Surgery are performed by doctors.
The type of surgery is only being selected after considering various factors such as type of glaucoma, severity, and age of patient.
Trabeculectomy is the creation of a drainage tube in the eye to bypass the obstruction site; however, this treatment will not work once and for all, and it may be necessary to continue to insert new channels, especially children. The glaucoma duct shunt operation involves placing a drainage device and a water flow tube on the surface of the eye to drain from the artificial duct.
“The operation is to keep the sight of patient. Even if the surgery was performed and the intraocular pressure was changed, the patient would have to continue to monitor the condition, because the pipeline may still be plugged later.”
Early detection and early treatment
Once the vision is destroyed, the treatment of glaucoma can only control the intraocular pressure and prevent the situation from deteriorating further.
Dr. Lee Ming Yueh: “Although I can’t get back your previous vision, but I can keep your current ones. The sooner the glaucoma is discovered, the less likely it is to suffer from blindness. Chronic glaucoma occurs slowly and has a high chance of treatment. Don’t give up.”
She lamented that some doctors have knowledge of glaucoma but do not know how to treat glaucoma patients well. As a result, these doctors do not recommend their patients seeking any specialist treatment. When patients start experiencing increased intraocular pressure and facing high risks of blindness, then these doctors only recommend their patients to specialists then.
In order to give patients a better understanding of glaucoma, Dr. Lee Ming Yueh has set up a website www.glaucomaspecialist.my , three years ago for providing more detailed instructions and treatment options.
The risk factors of glaucoma
- High intraocular pressure
- Some people in the family suffer from glaucoma
- Injured eyes
- Eye disease
- Hypertension or diabetes
- Long-term use of steroid hormones
*If you have any risk factors, you should perform an eye examination.
Types of glaucoma
Open Angle glaucoma
- The most common type.
- The patient does not feel pain in the eyes or feels a change in vision at the beginning because the vision begins to lose from the periphery.
- The field of vision is usually gradually reduced from the periphery to the centre; once it enters the later period, the sight will begin to get blurred.
- Although the angle between the iris and the cornea is normal, the drainage channel is blocked, causing the intraocular pressure to slowly increase, and then affecting the optic nerve.
- High intraocular pressure causes chronic, gradual damage to the optic nerve. Eventually the patient suffers irreversible blindness.
Angle Closure glaucoma
- Acute eye disease. Too much eye pressure can cause blindness within a few hours.
- The patient usually goes to the emergency room of the hospital to seek medical treatment. Because of severe eye pain, redness, and blurred vision, he may also see halo and rainbow colours around the light.
- Eye pain may also cause headaches, nausea, and vomiting.
- The angle between the iris and the cornea becomes narrower, and the iris moves forward, blocking the drainage channel and causing the intraocular pressure to rise above 50 mmHg.
- This type accounts for 20 to 30% of cases of overall glaucoma; about 50% of patients are blind due to this type of glaucoma.
- Causes high intraocular pressure due to trauma or other diseases such as inflammation of the eyes, cataracts, and diabetes.
- Overuse of steroid eye drops is also one of the causes.
- The youngest possible baby may be only 3 months old.
- May be primary congenital glaucoma or a secondary disease.
- Parents usually observe that children continue to shed tears and avoid light.
- Your child’s eyes will be more opaque and larger than normal eyes.