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illnesses and conditions

Glaucoma

NEXT time you book your car in for a service, have a think...when was the last time you gave yourself an MOT?

The human body is an amazing machine, but we tend to take it for granted and only get it checked out when something goes wrong.

Instead, regular ''servicing'' can help prevent serious trouble piling.

Take eyesight for example. If you've ever played blind man's buff (without peeping) you'll know how truly terrible it is to be without sight.

But shockingly, there are thousands of people in danger of doing just that and the tragedy is it doesn't have to happen.

Because the two major causes of blindness in the UK, glaucoma and diabetic retinopathy, are largely preventable.

More than 500,000 people in the UK are estimated to have glaucoma - one of the most common causes of 100 people over 40 in this country and numbers are increasing as people live longer.

In the north west alone there are believed to be more than 63,000 sufferers over 40, but nearly 16,000 will be unaware they have it and don't realise the potential threat to their sight.

A further 217,000 are believed to suffer from another condition, ocular hypertension, which is a warning sign of glaucoma, and also puts people at risk of losing their sight.

Glaucoma is an insidious condition. There are no symptoms, and as it creeps steadily, steadily on, with vision slowly narrowing to so called ''tunnel vision'', the first sign that many sufferers may know they are being robbed of their sight, is when they detect a loss of sight at edges.

Unless treated, glaucoma can cause partial or total blindness. But 90% of such blindness can be in the early stages.

That is why it is vital to have regular eye tests. Damage already done cannot be repaired but with early detection, regular checks and treatment, it is possible to arrest the condition, and keep damage to a minimum.

What is glaucoma?

Glaucoma is the name for a group of eye conditions in which the pressure inside the eye becomes too high.

This results in damage to the optic nerve at the back of the eye, which can lead to loss of vision.

The eye needs a certain amount of pressure to keep the eyeball in shape so that it can work properly.

There is a constant flow through it of a watery fluid, called aqueous humour, which is produced behind the iris (the coloured part of the eye).

It passes through the pupil (the hole in the centre of the iris) to leave the eye through tiny drainage channels.

But if it cannot escape, or too much is produced, the eye pressure will rise, putting pressure on the optic nerve which can then be injured.

There are four main types. In the most common, chronic glaucoma, the drainage channels become slowly blocked over many years. The eye pressure rises very slowly, and there is no pain to show there is a problem, but the field of vision gradually becomes impaired.

The danger with chronic glaucoma is that the eye may seem perfectly normal. There is no pain and the eyesight seems to be unchanged, but the vision is being damaged.

Early loss in the field of vision is usually in the shape of an arc, a little above and/or below the centre when looking straight ahead. This blank area spreads if the condition is untreated, with central vision to be last affected, so that it becomes like looking through a long tube - the tunnel vision - and in time even this would be lost without treatment.

Who is at risk?

Age - The longer we live, the more likely we are to develop glaucoma. Uncommon below the age of 40, it affects one per cent of people over this age and five per cent over 65.
Race - People of African Caribbean origin are between five and eight times more likely to develop the disease which may come on earlier than usual and be more severe.
Family - If there is a family history of the disease, you are more at risk. If you have a close relative who has chronic glaucoma you should have regular eye tests, especially over the age of 40.
short sight - People who are prone to the disease.
Diabetes - Is believed to increase the risk of developing the condition.

what can be done?

The main treatment aims to reduce the pressure in the eye and usually starts with eyedrops which act to open up the blocked drainage channels. If this does not work, laser treatment, or an operation may be needed.

The International Glaucoma Association, the only charity in the UK solely dedicated to preventing glaucoma blindness, is actively campaigning to encourage people to get regular eye health checks. The re-introduction by this Government of free eye tests for the over-sixties was a welcome boost to the prevention campaign.

Said chief executive David Wright: ''Comprehensive tests are not a mandatory part of an eye examination, so people have to ask specifically for all three glaucoma tests and choose an optometrist who can and will offer all three.

''The important thing to remember is that in neither glaucoma nor diabetic retinopathy can lost sight be regained, so the eye examination is a key element in a healthy eye routine.''

Diabetic retinopathy

An eye disease usually associated with long-standing diabetes. If left untreated, it can lead to blindness and is a major cause of poor vision in the UK.

The longer someone is diabetic, the higher their chances of developing the condition. Prolonged periods of high blood sugar levels cause damage to the small blood vessels in the retina at the back of the eye.

Though not entirely preventable, good control of diabetes helps to reduce the chances of it developing.

Because the vision is not usually affected by the condition until it is at a very advanced stage it is essential that all people with diabetes have their eyes examined once a year.

Eye tests are vital
Regular eye tests are sensible for everyone.

Over the age of 40 you should have one at least every two years, and ask for the THREE glaucoma tests to be done - not all optometrists do them automatically, so check, before you book an appointment - and make sure they do all three tests which are:

To look at the optic nerve by shining a special light into the eye.
Measure the pressure.
Field of vision test - you will be shown a series of spots of light on a screen and asked which you can see.

Links

Contact Numbers

The International Glaucoma Association: 020 7737 3265 The Royal National Institute for the Blind (RNIB): 0845 766 9999