World Glaucoma Week begins today…Let’s ‘Beat Invisible Glaucoma’

Mar 09, 2014 News

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By Romila Boodram
“Many people suffer with glaucoma and they don’t know it,” said Dr. Shailendra Sugrim, an ophthalmologist and Glaucoma Specialist at the Georgetown Public Hospital Corporation (GPHC).
Glaucoma is an eye disease in which the optic nerve (the nerve primarily responsible for sight) is damaged in a characteristic pattern. This can permanently damage vision in the affected eye(s) and lead to blindness if left untreated.

To emphasize its importance, the World Glaucoma Association and World Glaucoma Patient Association has dedicated a week annually to raising awareness about the disease. From today to next Saturday, World Glaucoma Week will be observed worldwide. The theme for this year’s campaign is ‘B.I.G- Beat Invisible Glaucoma.’
According to Dr. Sugrim, it’s called “invisible” glaucoma, because the disease acts silently by causing damage to the optic nerve without the patient having any notable symptoms. Hence, bit by bit over the years this damage continues, unknown to the patient, until the entire nerve is destroyed.
This nerve damage (called glaucomatous optic neuropathy) is permanent and cannot be reversed. Hence, at that time when the patient begins to start experiencing visual symptoms, they would already have had significant nerve damage. Thus, there is need for early screening of the disease.
Once glaucoma is diagnosed in the early stage, treatment can commence, and thereby prevent persons from becoming blind unnecessarily.
Statistics have shown that in 2010, 60.5 million people had glaucoma globally and given the aging of the world’s population, this number may increase to almost 80 million by 2020.
Dr. Sugrim explained that glaucoma can be categorised into two types: Open-Angle and Closed-Angle.
The angle refers to the area between the iris and cornea, through which fluid must flow to escape via the trabecular meshwork (a sieve-like structure).
In Open-Angle glaucoma, even though the angle is wide and open, slow clogging of the drainage canals can increase the eye pressure. In Closed-Angle glaucoma there is a closed or narrow angle between the iris and cornea. As a result drainage is obstructed and results in a sudden rise in intraocular pressure.
Dr. Sugrim related that glaucoma is generally a disease of aging, more frequent in patients over age 60, but if a person has other risk factors (genetic, structural and systemic) that can affect their drainage system, it can occur in younger persons.
In Guyanese patients, open-angle glaucoma is the most common form of this disease.
Patients of Afro-Guyanese origin are more prone to develop open-angle glaucoma and are more likely to have family members suffering from glaucoma. It has also been found that glaucoma in Afro-Guyanese patients is usually very severe and more difficult to treat.
Patients who suffer from closed-angle glaucoma and other secondary glaucoma may or may not have eye pains and other symptoms, but in general open-angle glaucoma does not routinely cause eye pains.
Treatment of glaucoma includes anti-glaucoma eye drops, laser treatment and surgery. The usual pattern is to start patients on anti-glaucoma eye drops and some patients can be prescribed as much as 4 different eye drops. If eye drops fail to control glaucoma, patients can then be given the option of having laser treatment or glaucoma surgery.
At the GPHC, the Department of Ophthalmology offers services for diagnosing and treating Glaucoma.
The hospital also offers daily eye clinics on weekdays where patients can be given eye examinations for the detection of Glaucoma.
Patients need to be referred to the hospital before they can obtain an appointment for any service. These referrals can be obtained from their general physicians.
Management of glaucoma at GPHC includes constant follow-up visits to the eye clinic to have the eye pressures being checked and for the ophthalmologist to evaluate whether the eye drops are controlling the glaucoma. The visual field examination results of patients are evaluated on a regular basis to ensure that the patient’s optic nerve is being protected from further damage.
The ophthalmologist posited that persons need to understand the importance of using their medications on time and in the correct manner.
At GPHC, the most common surgery that is offered for glaucoma is called Trabeculectomy. During this procedure, a piece of tissue in the drainage angle of the eye is removed, creating an opening. The opening is partially covered with a flap of tissue from the sclera (the white part of the eye) and the conjunctiva (the clear thin covering over the sclera.)
The new opening allows fluid to drain out of the eye, bypassing the clogged drainage channels of the trabecular meshwork.  As the fluid flows through the new drainage opening, the tissue over the opening rises to form a little blister or bubble, called a bleb.The bleb is located where the sclera, or white of the eye, joins the iris, the coloured part of the eye.
After surgery, the specialist would look at the bleb to make sure that fluid is still draining out of the new opening.
Unfortunately, once a patient has lost all function of their optic nerve there isn’t any option available currently to regenerate the nerve. Damage to the optic nerve is permanent – thus loss of vision is permanent.
This year, in observance of World Glaucoma Week, the Ministry of Health in collaboration with the Georgetown Public Hospital has created an information pamphlet on glaucoma that will be distributed at regional hospitals and health centres. The pamphlet, created by Glaucoma Specialist Dr. Sugrim carries basic information about glaucoma and how to get your eyes screened.
Chief Executive Officer (CEO) at the GPHC, Michael Khan in an invited comment said that he is very pleased with the services being offered by his Ophthalmology Department and promised to ensure that the public is provided with the best service. He further thanked Dr. Sugrim and the other doctors at the department for doing a wonderful job.

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