Friday, March 6, 2020

World Glaucoma Week: Arresting the Silent Thief of Vision



PRESS RELEASE:
WORLD GLAUCOMA WEEK (MARCH 8 TO 14, 2020) – ARRESTING THE SILENT THIEF OF VISION!

Vision is the most valuable of all human senses, yet every five seconds one person in the world goes blind and a child goes blind every minute, mainly because most people do not seek out preventive eye care. Furthermore, low vision and blindness affects not just the individuals, but also families, and communities. Globally, the life expectancy of blind persons is 1/3 less than that of their sighted counterparts, and most of them die within 10 years of becoming blind.

Sadly, ninety percent of blind people live in developing countries like Nigeria and 4 out of 5 blind people are needlessly blind. In Africa, the poor and blind live 20 years less than those who are only poor and 60% of children die within 2 years of becoming blind. In Nigeria, there are currently over 1 million blind adults over 40 years of age.

The most common cause of blindness globally, is cataract while uncorrected refractive error is the most common cause of visual impairment. Over one billion people who need eyeglasses worldwide lack access to glasses.

Whilst blindness from cataract is reversible via surgery, glaucoma is the number one cause of irreversible blindness globally. According to the International Agency for Prevention of Blindness (IAPB), there are approximately 80 million people with glaucoma, an increase of about 20 million since 2010 and over 3 million people are blind from the disease.

The term ‘glaucoma’ refers to a group of conditions that are characterized by damage of the optic nerve (the nerve that links the eye to the brain) and visual field loss. A major problem of glaucoma is that Glaucomaics (people with Glaucoma) usually lose vision before they notice any problems with their eyes; hence it is nicknamed “the silent thief of vision.” Moreover, about 50% of all glaucoma cases are undiagnosed in developed countries, and as high as 90% missed cases occur in developing countries.

World Glaucoma Week (WGW) - the second week in March - is dedicated to creating awareness on this silent thief of vision. This year (2020) WGW falls between the 8th of March, 2020 and the 14th of March, 2020. The main objective of this week is to eliminate glaucoma blindness by motivating people to have regular eye check, including optic nerve examination.

The main risk factors for the development of glaucoma include high intraocular (eye) pressure (although glaucoma can often develop with ‘normal’ intraocular pressure), increasing age, positive family history for glaucoma, ethnicity, short-sightedness and far-sightedness. Glaucoma can affect any age group including newborn babies but is more common in older adults. The most common type of Glaucoma also occurs earlier and is more severe in blacks than in whites.  Other risk factors for glaucoma include: eye injury, certain types of eye operation, long-term use of steroid medication, general health problems like diabetes mellitus, migraine, high blood pressure, and heart disease, among others.

Most forms of glaucoma affect both eyes, and do not have symptoms in their early stages. However, Glaucomaics (Glaucoma patients) may often complain of frequent change of glasses. If untreated, people with glaucoma will slowly lose their peripheral (side) vision but will not notice any change in their vision until the damage is very severe. As glaucoma progresses, people may miss objects to the side and out of the corner of their eyes. They may seem to be looking through a tunnel and eventually, straight – ahead (central) vision may decrease until no vision remains.

A typical case to illustrate the stealthiness of glaucoma is that of Mr. Noel. One day, as he poured fuel into his car, fuel splashed into Noel’s right eye. To his dismay, on closing the affected right eye, he noticed that he could not see with the left. He quickly went to the hospital and was told that he had glaucoma and was already irreversibly blind in the left eye. Like many Nigerian victims of Glaucoma, Noel ascribed his “mysterious” blindness to “juju” or “remote control”.

However, in a less common type of glaucoma (known as acute angle closure glaucoma), the following symptoms may occur: severe headache, severe eye pain, nausea/vomiting, blurred vision or red eye. Glaucoma in newborns may also manifest with gradual cloudiness of one or both eyes which could be present at birth or develop later, abnormal enlargement of the eyeballs (known as bull’s eye or buphthalmos), as well as painful red and swollen eyes.

Although glaucoma may not be preventable and glaucoma blindness is irreversible, the good news is that visual loss can be prevented by adhering to the following steps known as the A to I steps for arresting glaucoma blindness:

ACTIVITY: Exercise regularly. Moderate exercise may prevent glaucoma by reducing eye pressure. However, strenuous exercise should be avoided as it can raise the eye pressure.
BRUSHING: Brush and floss your teeth every day and see your dentist regularly. Recent research links gum disease with optic nerve damage in glaucoma.




CHECK-UP: Comprehensive eye screening every 4 years beginning at age of 40 years, for those with no glaucoma risk factor; then every 2 years after age 65. For those at high risk of glaucoma, screening should be done every two years from age 40 until age 50, and then every year thereafter, provided the initial assessment is normal.
DRUG alert: Always tell your ophthalmic surgeon (ophthalmologist) if you are taking any kind of steroids. This also applies to blood pressure medicine especially when taken at night. If the blood pressure drops too low during sleep, it can worsen glaucoma damage.
EAT WELL, SEE WELL: Eat plenty of leafy green vegetables and coloured fruits, berries and vegetables every day. They contain vitamins and minerals that protect your body and eyes. In fact, studies show that eye-healthy foods are better than vitamins at preventing glaucoma.
FAMILY History: Know your family’s eye health history. A family history of the disease increases the risk of glaucoma up to eight-fold and mandates immediate examination irrespective of age.
GUARD your eye: Wear eye protection when using power tools as serious eye injuries can lead to glaucoma. Also, wear quality polarized sunglasses and a hat to protect your eye from sunlight when exploring the outdoors. There is some evidence that the sun’s UV rays may cause a type of glaucoma.
HEAD positions. Glaucomaics and those at high risk of the disease should avoid placing their head below their heart for long periods of time as head-down positions can greatly raise the eye pressure. Also, Glaucomaics should avoid sleeping with the eye against the pillow or on the arm. If you snore heavily, get tested.
INTERVENTION (immediate): prompt commencement of treatment and strict adherence to follow-up

Glaucoma can be treated using medications (eyedrops or tablets), laser, conventional surgery or a combination of these. Treatment and monitoring of glaucoma is life-long. This is particularly important given the fact that while glaucoma treatment may save the remaining vision, it does not improve sight already lost from the disease. As a result, patients that are not enlightened and motivated may tend to discontinue their treatment and end up going blind. Sadly, this is a very common situation in our society. Therefore, Glaucomaics need to take their medications exactly as prescribed by the ophthalmic surgeon (ophthalmologist). It is also noteworthy that unlike cataract surgery, glaucoma surgery is better done early rather than later as surgery does not improve vision that is already lost. Finally, test for glasses cannot diagnose glaucoma and the use of glasses cannot prevent glaucoma blindness.

For this reason, mass medical mission, a foremost champion for preventive health care and national cancer control, has been incorporating preventive eye care into its free community-based preventive cancer care and health promotion (the Big War Against Cancer). This involves the use of the Mobile Ophthalmic Centre (nicknamed the PinkVISSION), to facilitate access to preventive eye services at the grassroots. The acronym VISSION stands for Voluntary Integrated Sight Saving Initiative of Nigeria. PinkVISSION aims to fight eye cancers and tackle the huge burden of needless blindness in Nigeria.

Other life-saving initiatives of mass medical mission include:

Mission PinkCruise (free community-based health outreaches with the PinkCruise)
Mission PinkDentist (the dental aspect of the free community outreach using Mobile Dental unit aka PinkDentist)
Free screening at the Lagos centre every Wednesday (Wellness Wednesday) and Friday (Family Friday)
Vaccine Fair to promote access to the quadrivalent vaccine which can prevent the various cancers caused by Human Papilloma Virus (this Fair holds every last Friday and Saturday of the month at the Lagos centre).

To mark the 2020 World Glaucoma Week, all are invited for free eye screening combined with cancer and dental screening on Wednesday, the 11th of March, 2020 and Friday, the 13th of March, 2020, at mass medical mission House, 31 Bode Thomas Street, Surulere, Lagos..

Groups could also apply to be included as hosts in the schedule of the on-going free community-based outreaches (Mission PinkCruise), by sending an email to info@pinkcruise.org.

Together, we can reduce the burden of cancer and blindness in our society!

- Dr Abia Nzelu
info@pinkcruise.org


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