Glaucoma may be source of your blurred vision

Okello Owino, 65, mistaking glaucoma for ordinary eye effects that come as a result of old age, only sought medical attention after his blurring sight vanished, following two years of deteriorating eye sight. The least he can do is trace opaque objects around him.

“I can only see some little light on the wall,” Okello says, adding that at first he did not take it seriously thinking it was old age taking toll on him.

Okello, a civil engineer by profession says, “one of my eyes was operated but I am yet to see any improvement.”
Irresolute about his fate, Okello, also a former civil servant, has retired and relies on his children for upkeep.

With the guide of a mobility aid, Okello is led by his grandson every time he has to go to Mulago hospital for review.
He remains hopeful that one day he will regain his sight and go about his business, however, doctors say this is far from possible.

What is glaucoma?
According to Dr Angella Nakandi Lwanga, a senior consultant Ophthalmologist (eye surgeon) at Naguru referral hospital, Glaucoma is a disease that damages your eye’s optic nerve. She says, “it usually happens when fluid builds up in the front part of your eye.” She explains that permanent loss of vision caused by glaucoma cannot be reversed.

The pressure in the normal eye, Dr Nakandi says, is between 10-20 millilitres of mercury but any pressure above 20, “we assume a patient has glaucoma.”

Although majority causes of glaucoma are not known, in some instances, glaucoma is due to trauma, injuries and other related diseases in the eye such as inflammation and cataracts, Dr Nakandi says.

The eyebrow, Dr Nakandi says, takes in fluids which nourish inside the eye and are supposed to come out in equal measures but for patients with glaucoma, for some, the water entering is too much and does not come out in equal measures.

“For those glaucoma cases in which causes are not known, we think that the channels which bring out water inside the eye are either narrow or blocked such that what enters the eye is more than what comes out,” she says.
Dr Nakandi adds that in almost 60 per cent of glaucoma cases, their causes are not known.

Types of glaucoma
Glaucoma is classified in two types, open angle and angle closure glaucoma.

With open glaucoma, Dr Nakandi says, the channels in which the fluid flows out are open but the small channels where the fluids in the eye flow out are thought to be narrow.
“But nobody has really come up with proper explanation and shown they are narrow.”

Meanwhile, Dr Nakandi says, patients with angle closure glaucoma, the eyelid turns and closes the angle especially in the evening when the pupil is dilated and closes the angle, the pressure raises
Open angle however, is more dangerous because it presents with painless symptoms whereas the close angle glaucoma presents with painful symptoms which force people to seek treatment in early stages, she says.

She adds that: “With open angle, by the time someone realises they have remained with minimal sight, the glaucoma is advanced. At such times, the patients start bumping to things.”

Treatment
Dr Jacob Ntende, an ophthalmologist at Mulago National Referral Hospital’s eye clinic says patients are treated with drugs though sometimes surgery is performed on the eyes.

“These drugs are taken for life so that the patient does not to lose the remaining sight, “he says, adding that this usually applies to open angle and angle closure glaucoma.

On the other hand, Dr Nakandi says, surgery is usually conducted on the secondary category of glaucoma which is usually due to eye infections such as inflammation among other causes.

“If the glaucoma is a result of the other eye defects, surgery is done to correct the deffects, for example, the leaking lens,” she says, it is because with secondary glaucoma you are treating the causes which you know.

Unlike the other common eye diseases such as cataract and refractive errors, among others, with glaucoma, once the sight is lost, it cannot be recovered even with treatment, Dr Ntende says.

“The best that can be done is to preserve the remaining vision,” he explains that: “glaucoma causes permanent blindness and the patient has to depend on drugs for life.”
In case of any remaining vision, however, the patient, he says, has to remain under constant review to prevent glaucoma from worsening.

In babies this condition can be easily diagnosed because the eyes are still soft that when the pressure rises the eye brows become bigger. This Dr Ntende says helps babies escape permanent blindness.