Catching glaucoma, the silent thief of sight

GLAUCOMA is a silent thief that robs people of their sight due to absence of symptoms, a specialist opthalmologist yesterday explained.

Mohan Ramalingam at the Raja Isteri Pengiran Anak Saleha (Ripas) Hospital told The Brunei Times that since the establishment of the Glaucoma Sub Specialty Unit at the hospital in 2009, 585 patients have been registered under its glaucoma registry.

"The registry and the specialty unit was set up to help us assess the risks of glaucoma, as well as detect 'at-risk patients'. With the registry, we have identified patients with glaucoma, (and have been regularly checking) their eye-status, treatment they are receiving and we even include their family details," he said.

The doctor described glaucoma as controllable but incurable disease and needs to be detected at an early stage.

Due to the nature of the disease, the Ministry of Health (MoH) and the Department of Ophthalmology Services are taking steps by extending the registry at hospitals in all districts.

"It is very important that we identify patients at risk such as a diagnosed patient's relatives, and our next step is to also conduct a population-based study so we will know the exact prevalence of patients with glaucoma in Brunei," said Ramalingam.

He explained glaucoma occurred when the pressure in an eye "went up", affecting the nerves of the eye. "When this happens, fluids in the eye which gives nutrients to structures of the eyeball cannot flow properly, causing the nerves to be affected."

However, Ramalingam explained there were two types of glaucoma open angle glaucoma and angle closure glaucoma. He said open angle glaucoma, which was the most common form of glaucoma in East Asia, was when a patient loses vision slowly without symptoms.

"Ten per cent of patients can be blind at the time of diagnosis. That is why we need to identify patients with glaucoma at an early stage, because when they come in at a late stage, we (might have to do) laser or surgery, depending on the condition. If 60 to 70 per cent of vision is lost already, then they are unfortunate patients," he said.

He added diabetics, patients with a family history of glaucoma, short-sighted people were at risk. However, "older people" were "most at risk".

Ramalingam urged the public to receive treatment at an early stage, to prevent the disease from progressing before experiencing vision loss, while angle closure glaucoma occurs when the pathway for fluid movement in the eye "was very narrow".

"When the pathway is closed, the pressure goes up in the eye. This form of glaucoma occurs with or without symptoms, 60 to 75 per cent of which are without symptoms. This means that a patient will slowly lose his/her sight," he said.

Patients who experienced symptoms were usually headaches, redness of the eye and a fall in vision.

During the launch of Brunei's World Glaucoma Day 2010 at MoH, head of the Department of Ophthalmology Services Nayan Joshi said: "A great number of people have been blind due to glaucoma globally. It is ranked the third biggest cause to blindness."

He added: "This year, the World Glaucoma Association has recommended to observe the World Glaucoma Week between March 7 to 13, and we join with the rest of the world by observing Glaucoma Week."

"With the creation of a glaucoma database, it will be extended to other district hospitals and within another six months, we will have a nationwide glaucoma database."

Meanwhile, Minister of Health Pehin Orang Kaya Indera Pahlawan Dato Seri Setia Hj Suyoi Hj Osman advised the public to go for regular eye examinations at least every two years.

"This is essential in order to avoid any unnecessary sight loss. In most cases, glaucoma has no symptoms, which means that up to 40 per cent of vision could be lost before it is noticed."

The minister said 60.5 million people worldwide "will have glaucoma by 2010", of which 4.5 million are already blind due to the disease.

He added: "The number will increase to 11.2 million by 2020. The reality is 50 per cent of people are unaware that they have glaucoma, and 10 per cent are blind in at least one eye at the time of diagnosis."

During Glaucoma Week, some of the activities include screening of government staff at their workplace, public screening at hospitals and group discussions for glaucoma patients and their families.

The Brunei Times