Glaucoma is common in both developed and developing countries, and it's estimated that 4.5 million have become blind from it. It is now the second leading cause of blindness.
What is glaucoma?
Glaucoma is actually a group of conditions characterized by damage to the optic nerve (the nerve that carries images from the eye to the brain). There are different types of the disease; the most common called primary open angle glaucoma. This is caused by clogged drainage channels in the eye’s draining channels, causing increased pressure in the eyeball. The result is a loss of vision. It develops gradually, and people may not realise they have it. On reaching an advanced stage glaucoma is extremely difficult and expensive to treat.
Glaucoma is often associated with ageing, though it is not confined to the elderly. People with glaucoma in their family history are far more likely to be at risk, and it is more prevalent among Afro-Caribbean, African and Asian communities.
Treatments for glaucoma
In developed countries, the key to reducing the incidence of glaucoma is early diagnosis. This is done by ensuring that a glaucoma check is part of a routine eye test. This involves measuring eye pressure using a jet of air, and examining the inner eye for symptoms.
In parts of Asia, Africa and the Caribbean, where eye tests are not as common, checking for glaucoma isn't easy. This makes the impact of the disease far greater as it is caught much later on, when it is difficult to treat.
Treating open angle glaucoma is done by lowering the pressure in the eye through:
- Reducing the amount of liquid produced in the eye using medication.
- Increasing the amount of liquid drained from the eyeball using surgery or laser treatment.
Medication normally comes in the form of eye drops, which often need to be administered every day, for life. As with other forms of long-term medication, this can prove difficult in places where 'Western' approaches to medication are not common practice. In poor countries, eye drops are also often either not available or very expensive.
Laser treatment is very costly and provides only a temporary lowering of pressure.
Surgery is the prime treatment for glaucoma in the developing world. It involves creating an artificial drainage hole in the eye, allowing the excess aqueous humor to drain from the eyeball. But surgery has its problems - it may fail, and it increases the risk of cataract.
Glaucoma is often linked to ageing and seen as a disease of the elderly, but it can affect people of all ages. Two-year-old Laurence Kitimbo from Uganda, pictured with his parents above, was born with glaucoma in one eye. He had poor vision, tearing and his eye was swollen and larger than the other.
His parents were understandably worried about his condition. But Laurence was lucky enough to undergo a Sightsavers supported operation to restore his sight. His parents are delighted with the result; for the first time in his life Laurence has clear vision and he will be going to school when he turns four!