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Glaucoma

Monday, 23 March 2009

Glaucoma is the world's second leading cause of Blindness. The term Glaucoma refers to a group of Eye diseases which damage the optic nerve, leading to vision loss. It is referred to as "the thief of sight", because it is usually painless, and it attacks the field of vision from the periphery. In 2008 alone, 80 people were registered blind as a result of Glaucoma

Today we have Martin O'Brien, President of Association of Optometrists Ireland in studio. We will also be talking to Dane Chan who suffers with glaucoma.

. World Glaucoma Day was on March 12th

Martin O'Brien Biog:
Currently I am in my second term as President of the Association of Optometrists Ireland. My Optometry degree was gained at City University London, after which I spent my Pre-Registration year in Northern Ireland with the then President of the College of Optometrists UK and passed my registration exams having my Diploma awarded to me at the Guildhall in London by my supervisor [and President, David Alexander]. Following this I spent a number of years working in Northern Ireland before returning home.

I have a practice in Carlow Town and since I returned home to Ireland I have been involved with the AOI. Over the last few years I have been a member of the AOI Council and held the position of Chair of PR Committee, Vice-President and currently President. In addition I am currently part of the examination panel for the Irish Professional Qualifying Examinations and have lectured / demonstrated at various Continuing Education events on behalf of the AOI. Also, I am the editor of and contributor to, Radharc Journal; the biannual education journal of the AOI.

Dane Chan Biog:
Dane is 32 and is originally from Malaysia, but has been living in Ireland for 11 years. He suffers with open angle glaucoma.

Dane was diagnosed with glaucoma in 1999, aged 22. He had always suffered with eye problems as a child, and was very short sighted. When he was 18 things seemed to get worse. He found it hard to see if he went from a bright room into a dark one, and found that his vision was becoming more hazy. He went to a local optician, who sent him immediately to the Eye & Ear hospital. They diagnosed glaucoma immediately and sent him to see a specialist in the Mater hospital. The condition was so severe that they operated immediately. Since then he has had a total of 25 operations. Unfortunately it was too late to save his sight and he is clinically blind. The operations can only reduce the pain and pressure on his eye.

What is glaucoma?
Glaucoma is an eye condition that causes damage to the optic nerve, which transmits images to the brain. The eye needs a certain amount of pressure to maintain shape and size. However, increased fluid can put pressure on the optic nerve and cause damage.

If glaucoma is not treated, damage can progress, causing a loss of peripheral, or side vision and may eventually lead to complete sight loss.

The eye produces a watery fluid called aqueous humour. Normally the fluid produced is balanced by fluid draining out but, if too much fluid is produced or if the drainage channels become blocked, then your eye pressure will rise. Too much pressure can damage the optic nerve.

Glaucoma has no symptoms in the early stages so you may not notice any pain or noticeable change in your vision. 40% of your optic nerve can be damaged before you notice any loss of vision. That is why it is so important to have regular eye exams. A routine eye exam could pick up glaucoma before you notice any changes to your vision and treatment may prevent any deteriorationg.

Glaucoma cannot be cured and the damage caused is irreversible. Progression of the disease can be managed and further deterioration of sight can be prevented if the condition is caught early.

Symptoms to look out for include a reduction in contrast between objects and their background, night vision problems and a loss of side vision. Glaucoma initially damages the peripheral (side) vision eventually leading to tunnel vision. Central vision may not be affected until a later stage. (Source www.ncbi.ie)

Who is at risk of developing glaucoma?

Those who are at risk of developing Glaucoma:
Age: 1 in 200 people up to the age of 50 will develop Glaucoma. However, that figure rises to 1 in 10 between the ages of 50 and 80. As you get older, your risk of developing glaucoma increases significantly.

Race; People of African origin are 5 times more likely to develop Glaucoma and 10 times more likely to lose vision more quickly because of the disease.

Family History; if someone in your family has or has had Glaucoma; you are more likely to develop it.

Health; People with health problems such as Diabetes or High Blood Pressure are more likely to develop Glaucoma.

Other risks; Long term steroid use and any surgery or injury to the eye also increases the risk.

How is it Diagnosed?
All Optometrists routinely check for Glaucoma. The full eye examination should take no less than 20 minutes to carry out.
All people over the age of 40 are screened for Glaucoma.
The Optometrist will;
. Talk to you about your family history and your own general health and eye history
. Check your Visual Acuities; what you can read on the testing chart
. Measure the pressure in your eyes. There are a number of ways to do this, your optometrist will explain.
. Shines a bright light into your eyes and examines the back of them. Your optometrist may need to put drops into your eyes to do this.
. Check your visual field using a special machine with flashing lights
. Sometimes, your optometrist may take a photograph of the back of your eye for recording purposes

None of these tests hurt and are often done as part of your routine eye examination

What is the Treatment?

If your optometrist suspects you may have Glaucoma, you will be referred onto an Ophthalmologist.
The Ophthalmologist will carry out further tests on your eyes.
If the Ophthalmologist confirms that you have Glaucoma, you will be started on treatment immediately.
Medications; you will be given one or a combination of different drops to take to lower the pressure in your eyes. Sometimes, it can take a few different trials of different medications to find what works for you.

Surgery; Normally the drops work very well to reduce the pressure, however, If the drops are not working to bring down the pressures enough, your ophthalmologist may decide to carry out surgery on your eye, to help the eye drain away this excess fluid inside the eye more quickly and this will lower the pressure in the eye.

How can I prevent myself getting Glaucoma?
You can't stop yourself from getting Glaucoma. However, early detection and treatment will prevent permanent damage occurring to the nerves at the back of your eye.
You should have regular eye examinations if you fall into any of the above categories (risk groups).
If you are diagnosed with the condition, take your medication regularly and return to your Ophthalmologist and Optometrist for regular monitoring and check-ups.

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