The eye condition that is turning into a major cause of blindness

Last month, the world marked the World Glaucoma week. During the week, eye patients were offered free checkup during a mass awareness exercise on the disease. Globally known as “the thief of sight”, glaucoma affects adults and children alike but the risk increases with age.
Dr Angella Nakandi Lwanga, a consultant ophthalmologist, and glaucoma eye specialist at Mulago National Referral Hospital, says glaucoma is a condition in which a lot of pressure is exerted on the eyes, which leads to pain, frontal headache and blurry vision.
She further adds that in most cases, it affects persons above the age of 40, although if someone has a history of glaucoma in the family, they could get it at any time since it is genetic.

Classification
The disease is classified into two types; open angle glaucoma, which is painless, and whose symptoms can only be identified when it is too late especially when one’s vision reduces. This kind is managed since chances are minimal that one’s sight can be restored once it has gone.
Dr Nakandi explains that even after surgery, the eye sight is not improved. “The surgery does not improve sight but it helps to maintain the sight a person has, so that they do not become blind.”
The second kind is angle-closure glaucoma, also known as acute glaucoma or narrow angle glaucoma.
It is more rare and is very different from open-angle glaucoma in that the eye pressure usually rises very quickly.
This happens when the drainage canals get blocked or covered, like a sink with something covering the drain. The pressure on the eyes stretches the retina and kills eye nerves.
When a person has glaucoma, doctors say the peripheral (side) vision is usually the first to be impaired.

Diagnosis
According to Dr Lwanga, glaucoma can be diagnosed by undergoing an eye pressure checkup to determine several things including sensitivity of the side vision, the point where glaucoma strikes first.
In normal eyes, the fluid flows at a rate of 10 to 21 millilitres. However, when a person’s eyes are affected by glaucoma, the flow is disrupted, occurring at 22 millilitres.
According to Dr Grace Ssali, a paediatrician ophthalmologist at Mulago hospital, for children with glaucoma, the best treatment measure is surgery.
“We carry out surgery on the eyes and although this does not cure the disease, it reduces the effect of the disease although, if the optical nerve is damaged it cannot be restored.”
Samuel Kasibante, a plumber shares that two years back, he realised he had glaucoma. Initially, he did not understand the condition until he went to the hospital. He is now blind in one eye and the other almost succumbed to the condition.

The numbers
Mulago hospital’s glaucoma clinic started in 2011 and has since registered about 600 patients.
“These are irregular because some never come back,” Dr Nakandi shares. However she notes that on average day, the clinic registers about 20 patients and out of these, two to four are new patients. In the past two months, between four and 10 new patients had been registered per week.
Glaucoma is painless and a person presents themselves when they are already blind and thus the doctors appeal to the public to undergo regular eye checkups since manypeople are becoming blind because of the disease.

Treatment for glaucoma
Modes of glaucoma treatment include eyedrops which are administered daily, surgery that involves cutting the eye to create smaller channels for the flow of the water out of the eye and laser treatment which is not very effective in Africa.
Dr Nakandi warns against self-medication but recommends regular eye visits to an ophthalmologist.

Life experience of suffering from glaucoma

Evelyn Pamela Aganyira a 22- year old student at Kampala University shares her experience of suffering from open angle glaucoma.
“I first developed a severe headache accompanied with spells of dizziness. I first went to a clinic and the first doctor I saw told me I was getting squints in the eyes. This was in 2007 and in April 2011, I went to the hospital ( Hoima Referral hospital) where the doctor told me that I was suffering from glaucoma but he advised me to go to Mulago for further checkups. I was then given eye drops.
On being told to go to Mulago, I ignored the doctor’s advice and used the eye drops he had given me. However, after a month of using the drops, the pain intensified and my sight was now blurry and I was told to discontinue the drops.
Eventually the pain stopped on its own. After about 10 months, the pain returned and I decided to go to Mengo hospital where I was given eye drops. Around March last year, I went to Mulago after the doctor in Mengo referred me there.
I had a checkup and the doctor confirmed I had open-angle glaucoma. I was given eye drops for a month and by this point, my pain had reduced.
In July 2014, I underwent my first surgery which was done in both eyes. My vision is still the same but at least I can see since I was almost becoming blind. After some time, my vision reduced and the headaches recurred. Thus on February 20, this year, I underwent my second surgery.
I have been on medication but I am now off and just coming for reviews with my doctor,” narrates Aganyira who recommends immediate medical attention for this kind of infection to be managed, because once the optical nerve is affected, glaucoma cannot be treated, leading to blindness.