This World Glaucoma Week, the Glaucoma Society of South Africa is sharing what to look out for so people know when to seek medical support.
South Africa (March 8, 2024) – Glaucoma is a group of eye diseases that damage the optic nerve, which is essential for good vision, and is one of the leading causes of irreversible blindness affecting more than 6 million people in Africa.
Shockingly, only 1 in 20 people know they have glaucoma, and 50% will be blind in one eye by the time they see their eye doctor for the first time.
In sub-Saharan Africa, glaucoma is estimated to affect 4.16% of the population aged 40 years and above, with a higher prevalence in the black population (5-7%) compared to the white population (3-5%). incidence is higher.
Despite being treatable, the South African Glaucoma Society (SAGS) highlights the major challenges faced, including lack of awareness, delayed diagnosis, inadequate follow-up visits and low adherence to treatment plans. ing.
Ophthalmology expert and SAGS President Dr. Marissa Willemse emphasizes that glaucoma, also known as the “silent vision thief,” does not show any noticeable symptoms in its early stages, making it extremely important to be aware of it. I'm emphasizing it.
“Loss of vision has devastating social, personal and economic effects, often leading to unemployment, loss of income, lower standards of living, depression and anxiety. Vision loss or blindness. Early detection of glaucoma is essential to increase the chances of preventing glaucoma.”
“If glaucoma is not treated, intraocular pressure (the pressure or force that builds up in the eye) increases and damages the optic nerve, which is responsible for transmitting visual information from the eye to the brain. Over time, damage to the optic nerve impairs vision. leading to loss of vision and, if progressing, irreversible blindness.”
She said access to eye care services, including glaucoma screening, diagnosis and treatment, is essential to effectively manage the condition.
“In South Africa, efforts are being made to improve access to eye care services, particularly in underserved communities where the burden of glaucoma can be high.”
Who is most at risk?
Dr. Willemse says that because there are certain risk factors for the development of glaucoma and that glaucoma often does not cause noticeable symptoms until it has already caused vision loss, the best way to detect glaucoma early is to have regular eye visits with an ophthalmologist. He says testing is important.
Risk factors include:
- Year: The risk of developing glaucoma increases with age, especially in people over the age of 60, but in Africa the age of onset of glaucoma is as recently as 40.
- Family history: A family history of glaucoma, especially in a first-degree relative (parent or sibling).
- Race or ethnicity: African Americans, Africans, Hispanics, and Asians are at higher risk.
- High intraocular pressure: People with high intraocular pressure (IOP) are at increased risk of developing glaucoma. However, not everyone with a high IOP will develop glaucoma, and even people with a normal IOP can develop glaucoma.
- Thin central corneal thickness: Research shows that people with thin corneas may be at higher risk.
- Medical condition: Certain medical conditions can increase your risk, such as diabetes, high blood pressure, and cardiovascular disease.
- Previous eye injury or surgery: Eye trauma or previous eye surgery.
- Myopia: The risk of developing glaucoma increases.
symptoms
As it progresses over time, certain warning signs will appear that should not be ignored. Dr. Willemse says, “It is important to note that some of these symptoms can also be caused by other eye diseases. A thorough treatment is necessary to find the root cause and determine appropriate treatment options. A thorough eye exam is required.”
- Gradual loss of peripheral vision: Glaucoma often first affects peripheral vision, often resulting in tunnel vision, or blind spots on the sides or corners of the field of vision. Patients are often diagnosed only after they fail their driver's license renewal exam.
- Blurry vision: Blurry or hazy vision may indicate damage to the optic nerve.
- Halo around the light: Some glaucoma patients may experience a halo or glare around lights, especially at night.
- Eye pain or redness: In some cases, eye pain, redness, and discomfort may be detected.
- Nausea or vomiting: Severe cases of acute angle-closure glaucoma can cause symptoms such as nausea, vomiting, and severe eye pain. This is an emergency situation and the patient may lose vision within hours of angle closure starting.
Glaucoma screening
It is recommended that people under 40 be screened every 2 to 4 years, people between 40 and 60 every 2 to 3 years, and people over 60 every year.
Glaucoma screening usually involves a comprehensive eye exam that includes several tests to assess the health of your eyes and detect signs of glaucoma.
- intraocular pressure measurement: Measures the pressure inside the eye (intraocular pressure) using a tonometer. Elevated intraocular pressure is an important risk factor for glaucoma.
- Fundus examination: The eye doctor examines the optic nerve at the back of the eye for signs of damage or abnormalities related to glaucoma.
- Visual field test (visual field test): This test measures visual acuity in the peripheral areas to detect blind spots or areas of decreased vision that may indicate damage to the optic nerve.
- Gonioscopy: The ophthalmologist examines the drainage angle of the eye to determine whether the eye is open or closed. This can help diagnose certain types of glaucoma.
- Special investigations such as optical coherence tomography: The optic nerve and nerve fiber layer can be monitored to check for early changes and progression of glaucoma.
treatment options
“Once the screening is complete, the ophthalmologist develops an individualized treatment plan for each glaucoma patient,” explains Dr. Willemse. “It is important that patients adhere to the plan and attend regular follow-up visits to monitor eye health and ensure that the condition is properly managed. Maintain vision and prevent vision loss It cannot be overstated how important early detection and treatment of glaucoma is to prevent this.”
She said the main goal of treatment is to lower intraocular pressure and prevent further damage to the optic nerve. This can be done with drugs used to protect the optic nerve from oxidative stress and damage.
Eye drops are often prescribed to lower intraocular pressure in glaucoma and can also be used chronically to prevent intraocular pressure from rising. Laser treatment may be used to improve fluid drainage from the eye and lower intraocular pressure. If drugs and laser treatments are ineffective, surgical treatment may be recommended.
Dr. Willemse emphasizes the importance of awareness, encouraging regular eye exams, early detection, and appropriate treatment for effective glaucoma management. For people living with glaucoma and their families, access to support networks and resources is essential to navigating treatment and care.