Writeen by Dr. Niranjan Pehere & Dr. Vickie Faiyah Sam, Liberia Eye Center- L V Prasad Eye Institute Liberia (Inc), John F Kennedy Memorial Medical Center, Monrovia, Liberia
What is Glaucoma?
Glaucoma is a group of diseases that cause progressive damage to the optic nerve (nerve that connects eye with brain) due to increase in pressure in the eye. Normal eye pressure should be less than 20 millimeters of mercury (mmHg).
What are the symptoms of glaucoma?
In majority of cases, patient does not experience any symptoms in initial stages of the disease because the vision is lost in peripheral parts and central vision remains intact till late stages of the disease, as seen in the picture below. Hence glaucoma is called as ‘silent thief of sight’.
There are a few types of glaucoma (angle closure glaucoma) that can present with sudden, painful loss of vision, but this type of glaucoma is less common in Liberia.
Who is at increased risk of developing glaucoma?
Following are the risk factors for glaucoma:
- African race: All Liberians are at increased risk by virtue of being Africans.
- Some tribes are more predisposed: In our experience, we have seen that people from Lofa county are even at a higher risk of developing glaucoma.
- Age: Any Liberian above the age of 40 years is at risk of glaucoma.
- Family history of glaucoma: Glaucoma can run in families. So if any person in the family is diagnosed to have glaucoma, his/her siblings and children must undergo an eye check-up to rule out glaucoma.
- Injury to eye: Any injury to the eye increases risk of glaucoma
- Patients using steroid medications for any problems: Many people use steroid eye drops from pharmacies for any eye problems like itching, redness etc. Some use steroid tablets for several diseases. All these people are at increased risk of developing glaucoma
Anyone with any of the above risk factors must visit an eye doctor to check if he/she has glaucoma. That’s the only way to diagnose glaucoma in early stages.
It is important to remember that checking how much you can read on the vision chart and getting eye glasses is just a part of eye examination. There is a lot more that needs to be examined in the eye to know if you have any eye problems.
Who can make a diagnosis of glaucoma?
A qualified eye doctor with extensive training managing glaucoma can make a diagnosis of glaucoma. The eye doctor measures the eye pressure, just like a general doctor measures blood pressure. Generally, when eye pressure goes above 21, person can develop glaucoma. But it is important to note that in several cases of glaucoma, the eye pressure may even be less than 21 and yet they can lose vision. So, eye pressure is just one of the several parameters that a doctor considers while making diagnosis of glaucoma. The other parameters include careful examination of the optic disc (the back of the eye), gonioscopy (examination of a structure inside the eye called anterior chamber angle) and visual field test (test that tells how well you see on sides). A collective interpretation of all these helps in establishing diagnosis of glaucoma.
How is glaucoma treated?
The aim of treatment in glaucoma is basically to preserve the remaining vision. There is no way to recover the vision that is already lost. Glaucoma can be treated by following means:
- Medications: Eye drops, tablets
- Surgery
- Laser
We often need to combine these treatments depending on severity of disease.
Following the treatment properly and visiting the eye doctor as per advice is the key for preserving the vision.
Can glaucoma affect children too?
Yes, although rare in children, glaucoma can affect children too. Sometimes they can be born with glaucoma or may develop it later in childhood. Eyes of such babies look larger than normal and their cornea looks hazy. Some children who suffer from eye allergy and use steroid eye drops indiscriminately, also develop glaucoma. Glaucoma in children after requires an eye surgery.
What treatment facilities are available at the Liberia Eye Center for glaucoma?
We at the Liberia Eye Center, run by the L V Prasad Eye Institute, at the John F Kennedy Medical Center, Monrovia provide comprehensive glaucoma care from diagnosis to surgery, to all our patients irrespective of their ability to pay. We also keep innovating ways to deal with this complex problem in our country.