FAQs About Glaucoma and Its Management

It is a beautiful day today, the weekend has started early for me because I have taken permission from work and traveled to the Western Region of Ghana to attend @anaman's wedding this weekend.

And so I am here for the weekend, however, that does not deter me from sharing my usual ocular health tips with you and since we are already doing a Glaucoma awareness celebration this week, I have decided to focus solely on glaucoma for this week so that together we can learn as much as we can. I am optimistic that you would understand enough by the end of this week to do the needful.

And so for today we would be looking at some of the frequently asked questions that I get from my patients and my friends who would want to know more about the condition and then we would look at some of the management protocols for the condition. I hope you enjoy the read and learn a thing or two from what we have to share today.

Let's do a quick recap of the things we have learned so far since we started with our glaucoma awareness education and then we can proceed to what we have to share today. From what we know so far, glaucoma is a degenerative condition of the eye which comes with a characteristic visual field loss due to the death of the optic nerve cells. The condition mostly comes about with an increase in intraocular pressure however this may not always be the case.

Glaucoma doesn't give any symptoms hence the name the silent thief of sight, the condition is best diagnosed by Your Optometrist or Ophthalmologist after a comprehensive eye examination with supporting tests such as the visual field test or the ocular coherence tomography test. Having a sibling diagnosed with the condition is a risk factor you may need an eye examination to rule it out for you.

Again, being of African descent increases your chances of developing glaucoma however open-angle glaucoma is more prevalent among African descent and Latinos whereas close-angle glaucoma is most common among people of eastern descent. Women are more likely to develop the condition as compared to men, people with underlying conditions such as hypertension and diabetes are more likely to develop the condition, and last but not least the use of certain drugs may increase or decrease your chances of developing glaucoma.

Whenever one hears the condition of glaucoma for the first time and learns that it is an eye condition that may result in blindness they ask lots of questions to find ways and means to protect themselves and their families. During this glaucoma awareness week celebration, I had a few people ask me some questions about glaucoma which I am going to share and also provide the answers to. So let's see about it.

• Can Glaucoma Be Prevented?

Since the specific cause of glaucoma is not yet known, I would not say that it can be prevented because it is not like a vitamin A deficiency or something similar however looking at some of the causes of Glaucoma such as long-term steroid usage, the excess intake of caffeine and the likes, we can that changing your habits with regards any of these could probably help you avoid the condition.

Having good habits such as frequent intake of fruits and vegetables, the use of vitamin C which is the most powerful antioxidant when it comes to the eye, exercising regularly, etc could do your eye a lot of good and offer some protection against glaucoma as a condition however that is not a preventive measure.

• How can I tell if I have glaucoma

You cannot tell you have glaucoma, glaucoma is best diagnosed by an Optometrist or an Ophthalmologist and even that tentative diagnosis has to go through some series of tests for verification before treatment may be initiated for a patient. And so to be on the safer side, having a comprehensive eye examination is the way to go.

When in doubt as a professional, that has already been my mantra do not try to attribute your pain or discomfort to glaucoma, the only glaucoma may cause that is noticeable is the gradual loss of vision which become apparent in how a patient navigates around when getting to the end stages because their peripheral vision is gone and they keep bumping into objects.

• I have been using my glaucoma drugs for so long and I do not see any improvement, can I stop?

I had a patient ask me this sometime back when they came in for their first consult at my facility after having been diagnosed some years back and being put on treatment. Apparently, she did not really grasp the concept and education behind the condition and was probably thinking that she may have to use the drug for a while and then she would heal with time and be ok but when things weren't getting better she was getting fed up.

That was when a friend recommended our facility to her so that she may find a permanent solution to her problem when she comes, fortunately for her, her coming granted her the opportunity to relearn and understand the circumstances involving her condition and the importance of not stopping the medication. Unfortunately for her, it was a burst of her bubble and her hopes went down the drain. But then please let's know that glaucoma is a lifetime condition that needs lifetime treatment, you are probably going to use the drugs to the very end of your life and so please know this.

Managing Glaucoma is a skill that comes with years of learning and experience. This is mostly done with the aid of tests such as OCT, VFT, and IOP. Knowing the current state of the eye and the pressure would help you determine as an OD whether you should use a particular type of drug.

Ocular drugs for the treatment of glaucoma come in different categories all of which work differently and have different effectivity or potency. Most often the first line of management involves the use of beta blockers example of which is timolol to get the pressures of the eyes to a specific target. This has made timolol quite popular amongst patients. Beta-blocker reduces aqueous production by binding to the beta receptors in the ciliary body of the eye.

Then there are the prostaglandin analogs such as latanoprost which works by increasing the uveal-scleral outflow of aqueous and thus lowering the intraocular pressure. They are more expensive than beta-blockers on most occasions and may be added to beta-blockers when they seem not to get the work done anymore. There are also carbonic anhydrase inhibitors that also work to reduce IOp by reducing aqueous production.

The management protocols work best with a combination of different classes of antiglaucoma drugs together, in cases of acute IOP rise or situations where the pressure may be extremely high, it becomes imperative that systemic drugs are added and so the use of acetazolamide produces good results in lowering pressure quickly. The only issue with this is that its diuresis property causes sodium and potassium loss from the body which may need replacement in other forms.

Please do not try to manage your glaucoma on your own if you have been diagnosed, your optometrist would know the best treatment regime that would benefit you the most. Remember that the purpose of this article is not so you could diagnose and treat yourself but so you would understand the condition in which you find yourself to help facilitate your understanding and treatment process.

Remember that glaucoma can cause you to actually go blind, do not start and stop your glaucoma treatment, during your glaucoma treatment do well to let your Optometrist know if you develop any changes in your vision, do not just stop out of your own will and if you feel you may have allergies to any of the groups or class of treatment please kindly report right away.

Remember that good life ought to be lived well, it starts with the right choice for yourself, one such choice is getting a comprehensive eye examination. Also, remember that during this process lots of facilities would be organizing free eye examinations in line with the awareness program, take advantage and get yourself checked. Any questions you may have is welcome, thanks for your time and for reading.