Don’t let the sneak thief steal your vision from you

There is no cure for glaucoma as yet. Therefore early detection is essential to limiting visual impairment, writes Mohammed Sohaib Mustafa

Last month’s glaucoma awareness week was an initiative to raise public understanding of the second leading cause of blindness worldwide.

Each year it presents an opportunity to highlight the importance of early detection of glaucoma, and the treatment options available in the UAE. Screening for the disease and then compliance with the treatment regime are two important messages for the community to absorb.

Glaucoma is a group of eye diseases that cause progressive damage of the optic nerve at the point where it leaves the eye to carry visual information to the brain. According to the World Health Organisation, the number of people estimated to be blind as a result of primary glaucoma is 4.5 million, accounting for slightly more than 12 per cent of all global blindness. The primary risk factors that are linked to the onset of the disease are age and genetic predisposition.

Some forms of glaucoma may occur at birth (“congenital”) or during infancy and childhood (“juvenile”). In most cases, glaucoma appears after the fourth decade of life and its frequency increases with age. Further risk factors include genetics and family history, and other conditions including diabetes, which is very common in the UAE.

Glaucoma currently affects more than 60 million people worldwide. Unfortunately, many are unaware that they have it until there is a large amount of irreversible vision loss.

If left untreated, most types of glaucoma progress (without warning or obvious symptoms to the patient) towards gradually worsening visual damage and may lead to blindness. Once incurred, visual damage is mostly irreversible, and this has led to glaucoma being described as the “silent blinding disease” or the “sneak thief of sight”.

It was once believed that the cause of most or all glaucomas was high pressure within the eye (known as intraocular pressure – sometimes abbreviated as IOP).

It is now established however, that even people without an abnormally high IOP may suffer from glaucoma. Intraocular pressure is considered therefore today as a “risk factor”, together with other factors such as racial ancestry, family history, high myopia and age.

There is no cure for glaucoma as yet. However medication or surgery can halt or slowdown any further vision loss. Therefore early detection is essential to limiting visual impairment and preventing the progression towards severe visual handicap or blindness. An eye-care professional can detect glaucoma in its early stages and advise on the best course of action.

Screening for glaucoma involves a mandatory eye pressure check, evaluation of the optic nerve at the back of the eye by a specialist doctor and visual fields test if any changes are seen at the previous exams. All tests are pain free and easy to assess the disease when performed in proper ophthalmic hospitals or clinics.

At Moorfields Dubai, we see a wide ranging spectrum of cases ranging from patients who have established early glaucoma and are compliant with treatment to patients who have uncontrolled glaucoma and either non-compliant with medication or indeed as we have highlighted above, don’t even know they have the condition.

Dr Mohammed Sohaib Mustafa is a consultant glaucoma surgeon at Moorfields Eye Hospital Dubai