Glaucoma is the second leading cause of blindness in the world after cataract. Research has shown that about 50% of the world’s glaucoma cases come from the Asian population, and in Malaysia itself, the prevalence of this disease is increasing.

Those with glaucoma have optic nerve damage due to fluid buildup in the eye. The good news is, early detection and treatment can often protect against serious vision loss.

The primary cause of glaucoma is increased intraocular pressure, or high pressure within the eyeball. In most cases, this is owing to fluid buildup in the front part of the eye, which puts pressure on and gradually damages the optic nerve.

Untreated or poorly managed glaucoma can lead to permanent and irreversible vision loss and blindness.

Three types of glaucoma have been seen in the adult population: open-angle glaucoma, which is the most common; closed angle glaucoma; and normal-tension glaucoma. Yes, glaucoma could still happen in those with normal eye pressure!

Several factors can contribute to the development of glaucoma, particularly in the elderly:

• age: people over 60 have a higher chance of developing glaucoma;
• genetics: a family history of the disease significantly increases risk;
• medical conditions such as diabetes, heart disease, high blood pressure, and sickle cell anaemia;
• eye conditions: severe eye injuries, retinal detachment, eye tumours, and inflammation could lead to glaucoma;
• prolonged use of corticosteroids: extended use of these medications, especially eye drops, has been linked to increased risk.

Glaucoma symptoms

Glaucoma is often called the “silent thief of sight” because it typically has no indicators in its early stages. However, as the disease progresses, symptoms become more apparent, including:

severe eye pain with red eyes that may be accompanied by nausea and vomiting;
patchy blind spots in peripheral or central vision, often in both eyes;
tunnel vision – a narrowing of one’s sight – in advanced stages;
sudden onset of visual disturbances, including blurred vision and halos around lights.

Regular comprehensive eye exams are the best way to detect the condition early, which is crucial to prevent significant vision loss.

A thorough glaucoma evaluation includes tests to measure the pressure within the eye, examine the shape and colour of the optic nerve, check the patient’s complete field of vision, and measure the thickness of the cornea, among others.

These tests help in determining not just the presence of glaucoma but also its type and severity.

Treatment options

While there is no cure for glaucoma, further vision loss can often be halted by lowering pressure on the eye. Treatment options include:

• Prescription eye drops: Often the first line of treatment, these either reduce the formation of fluid in the front of the eye or increase its outflow, lowering eye pressure.
• Oral medications: When eye drops alone don’t bring the pressure down to the desired level, oral medications can be added.
• Laser surgery: Techniques like trabeculoplasty, iridotomy, and cyclophotocoagulation can help fluid drain out of the eye.
• Microsurgery: Trabeculectomy is a procedure where a new drainage channel is created to ease intraocular pressure.
• Minimally invasive glaucoma surgery: This is a newer category of surgical procedure that aims to reduce eye pressure with less risk and faster recovery times compared with traditional surgeries.

While there is no cure for glaucoma, you can manage symptoms and stop the disease from getting worse. Management involves regular follow-up appointments to monitor the condition and adjust treatment as necessary.

Adhering to prescribed treatments and maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help. It is equally important for elderly patients to seek support, as dealing with a chronic condition can be emotionally challenging.

In conclusion, understanding the causes, symptoms, and treatment options for glaucoma is crucial, especially for the elderly. Always consult your doctor in the event of vision disturbances or eye discomfort.

With appropriate treatment and management, individuals with glaucoma can maintain their quality of life and preserve their vision.

This article was written for Alpro Pharmacy, a dedicated community pharmacy committed to providing opportunities, health, and guidance to anyone striving for a better life. Speak to their professional healthcare providers at 019-702 1923.

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