Glaucoma
Glaucoma is a condition where the pressure inside the eye exceeds the optic nerve fibres. When pressure builds up in the eye, Known as Intraocular pressure (IOP), the clear liquid called the aqueous humour which normally flows in and out of the eye, is prevented from draining properly. The resulting increase in pressure within the eye can damage the optic nerve.
As optic nerve fibres are damaged by GLAUCOMA, small blind spots may begin to develop, usually in the side – or peripheral – vision. Many people don’t notice the blind spots until significant damage to the optic nerve occurs leading to loss of vision & blindness if untreated.
In Nigeria, glaucoma is a devastating and often neglected problem. It is a leading cause of blindness, second only to cataract. Glaucoma in Nigeria is predominantly open angle glaucoma (OAG), which begins at an earlier age in Black People than in Caucasians (people of European descent) and the disease typically advances rapidly. In the majority of cases diagnosis is made late after loss of central vision in one or both eyes.
Glaucoma in Nigeria in the over 40 age group has been estimated at over 10%. High prevalence, early onset of disease, and an aggressive course combine to produce a high rate of blindness due to glaucoma. It is therefore extremely important that the risk group must present themselves for twice yearly eye checks.
Symptoms of Glaucoma
Glaucoma does produce noticeable symptoms, which include:
* Blurred vision.
* Severe eye pain.
* Headaches.
* Halos (which may appear as rainbows) around bright lights.
* Nausea and vomiting.
Who is at risk?
Black adults aged 40 years and above are at greatest risk of contracting Glaucoma. Other high-risk individuals, including people, who have relatives who have, or have had Glaucoma, diabetics and very nearsighted people.
Diagnosis
Glaucoma can be detected using a simple and painless measurement of pressure in the eye. This test is called tonometry.
Four criteria are used to diagnose Glaucoma:
1) Pressure within the eye,
2) The appearance of the meshwork,
3) The appearance of the optic nerve,
4) The individual’s visual field, particularly peripheral vision.
Treatment
The type of treatment to be used in Glaucoma cases depends on the severity of the damage done to the optic nerve. Ideally, open angle Glaucoma can be controlled by daily drops or medications used daily. If these methods fail to decrease the pressure inside the eye, Laser Treatment or surgery will be necessary to relieve the pressure. It is pertinent here to note that vision lost due to damage to the optic nerve cannot be restored Medication, Laser treatment (Argon laser trabeculoplasty) or surgery (sclerectomy or Trabeculectomy) can only prevent further loss of sight. Glaucoma can only be stemmed, it cannot be cured.
For patients with Glaucoma and cataract, Maxivision surgeons have perfected the most modern method in the world for dealing with this combination of problems – non-penetrating deep sclerectomy (NPDS) combined with phacoemulsification (phaco-NPDS) during the same operation, The surgical strategy decision is necessarily customized to every patient by the Maxivision Laser Eye Centre ophthalmologists. Usually, they will adopt filtering surgeries for glaucoma patients with incipient cataract, and combined phacoemulsification with non-penetrating deep sclerectomy for progressive or advanced glaucoma, which achieves much better results with a much reduced rate of complications.
Standard diagnosis and consultation with Ophthalmologist:
*Visual acuity assessment.
*Bio microscopy.
*Ophthalmoscopy.
*Computerized AutoRef-Keratometry.
*Non Contact pneumatic Tonometry.
Specialized investigations:
*Computerized ultrasound B scanning.
*Computerized ultrasound Echobiometry.
*Computerized Perimetry (Visual field analysis).
*Computerized Keratotopography.
*Digital ultrasound pachymetry.
*Binocular ophthalmoscopy (Fundus examination).
*Gonioscopy
Glaucoma is the name given to a range of conditions in which the majority have increased pressure within the eyeball, leading to permanent, and irreversible damage to the optic nerve, with eventual blindness if left untreated..
