Glaucoma: Half the cases in poor States

By Harold Ayodo

Ms Patricia Wanjiru has used eye drops for five years after a doctor diagnosed her with Glaucoma, an eye disorder.

She developed poor vision in 2003 and sought treatment at Kenyatta National Hospital where she was diagnosed with the condition and prescribed for the treatment for life.

Glaucoma – a leading cause of irreversible blindness — is a disease that causes progressive damage of the optic nerve and visions that result in blindness, if untreated.

"I went to see an optician assuming she would recommend spectacles, but she referred me to Kenyatta," Wanjiru recalls.

Lucky few

As the world marks Glaucoma Day today, Wanjiru is among the lucky few for many have lost sight because of late diagnosis of the disease.

Experts say thousands of Kenyans unknowingly have the disorder.

Statistics from the Ministry of Health show that 25,000 of 200,000 people with the disorder are blind.

Kenya is among the countries with high reported cases of the disease that afflicts over 67 million people worldwide, including 6.8 million Africans.

Aga Khan University Hospital Ophthalmology Section Head, Daniel Kiage, says nearly 80 per cent of Nairobi residents could be having the condition but they have not been identified because they have not undergone eye check-ups.

Dr Kiage, a Glaucoma specialist and eye surgeon, says cases of people becoming blind from the chronic condition could be contained with regular eye examinations.

Lack of obvious symptoms made vision experts describe it as the ‘sneak thief of sight’. "Many people know their status late when irreversible loss of vision has occurred," Kiage says.

People of African decent over 40 face a high risk of contracting the disease. "History of Glaucoma in the family, myopia (short-sightedness) and diabetes increases risk of getting the disease," he says. Other risk factors include wearing eyeglasses from a young age, high cholesterol levels and overweight.

Medical journals say regular eye check-ups by specialists is the only way to detect Glaucoma and contain loss of vision.

Kiage recommends children undergo eye check-ups when they reach age five and regularly after 40.

Vision experts concur that people under 40 be tested for Glaucoma every three to five years and those over the age once every two years.

Tests involve analysis of intraocular (eye) pressure, optic nerve and a detailed examination of the visual field. "People with intraocular pressure of over 21 millilitres mercury (mmHg) are more likely to suffer from the disease," Kiage says.

Doctors say damage to the optic nerve is responsible for the loss of vision in Glaucoma patients.

The optic nerve acts like an electric cable with over a million wires and is responsible for carrying images to the brain

Treatment involves easing of the eye pressure to prevent a further loss of vision. Eye drops can reduce pressure and follow-up treatments include laser surgery and other surgical procedures are follow-up treatments.

Detect early

"Screening can help detect the disease early…it involves checking medical history, eye pressure and general examination of the optic nerves," Kiage says.

However, nearly 10 per cent of people with Glaucoma who receive proper treatment still experience loss of vision. "The disease requires discipline …I walk with an eye drop in my bag," Wanjiru says.

Kiage says the disease is not expensive to treat.

"Eye surgeries in district or public hospitals cost about Sh4,000 in public hospitals…laser treatment in Aga Khan cost about Sh5,000," he says.

He admits the country lacks Glaucoma specialists but adds that doctors have the capacity to detect and contain the disease.

The disease remains a threat locally even as the WHO strives to eliminate avoidable blindness by 2020 under the slogan Vision 2020: The Right to Sight.

WHO figures show that 50 per cent of affected people live in the developed world and 90 per cent in developing countries like Kenya are not aware they have the disease.

A recent survey by the American Glaucoma Research Foundation ranked Glaucoma third after cancer and heart diseases as a disease of disability which people fear.