Severe headache, nausea, vomiting, blurring of vision, pain in the eyeballs, halos and watering from the eyes — when you experience either of these sensations, you perhaps won’t take it seriously. Only when it becomes unbearable, will you visit your eye doctor, perhaps waiting till the last moment. You are impatient for the doctor’s diagnosis and when the wait is over, it will perhaps be discovered that you are suffering from — glaucoma. 


Though scary, this is a possibility. But the point is not to scare you; it is only to make you aware. And if you already have an idea, then spread the word. This is essential because “most of glaucoma is detected late as it is symptom-less,” says Dr Sudhir Gautam, Medical Director and ophthalmologist at Lions Eye Hospital.



But what about the aforementioned aspects, are they symptoms? “In some type of glaucoma, patients come up with such symptoms,” mentions Dr Gautam. 



Adding more on the point, Dr Manmohan Lal Shrestha, Ophthalmologist at Nepal Eye Hospital says, “Dizziness, photo phobia and unable to look at the light can also be considered as some of the symptoms.”



What is Glaucoma?



Of course only knowing the symptoms is not enough; you have to have sound knowledge about what glaucoma is. “Constant or intermittent, permanent or temporary rise of pressure of the eye ball beyond the tolerance limit of an individual causing permanent or temporary, structural or functional damage of optic nerve,” answers Dr Gautam. In layman’s term, like high blood pressure, even the eyes have their pressure and when its high, the optic nerve, the main nerve responsible for vision, gets damaged due to which vision depletes leading to glaucoma.



Of course understanding about glaucoma, a question immediately props up, why does it occur or what are its causes?



“Drainage of the fluid (aqueous humor) inside the eye into blood vessels is obstructed and the pressure in the eye is raised that damages the optic nerve,” informs Dr Gautam.



This fluid is like food for the eyes, it consumes as required and discards the excess, “but when it stops processing in such a manner, you suffer from glaucoma,” adds Dr Shrestha.



With this you have to know the different types of glaucoma. Some important types are, open angle glaucoma, narrow angle or angle closure glaucoma, congenital glaucoma, normal tension glaucoma etcetera.



Vulnerable ones



Usually most of the diseases are age-specific, but it’s not the same with glaucoma, because anybody can get it, “commonly it is inherited”. Nonetheless, glaucoma is not very common in Nepal, “those who suffer from it, usually go blind because of ignorance about the condition,” mentions Dr Gautam and Dr Shrestha and they further add that “most of the glaucoma cases in Nepal are detected during routine check-ups of the eye”.



So people with a family history ought to go for a regular check-up. And, “an ideal time for regular check-up is every six months,” advises Dr  Shrestha. He also highlights that if glaucoma in the west is the second main cause of blindness, in Nepal it is the third. “It has been found out that suffering from glaucoma depends on the lifestyle, however, the reason is still unknown.”



Besides this, there are people who are at increased risk of getting glaucoma. “Children of glaucoma patients, long term use of steroid drugs, trauma, diabetes, hypertensive retinopathy, and structural defect of eye are the risk factors for glaucoma,” says Dr Gautam.



Referring to the eye structure Dr Shrestha explains that “frequent power change is a reason to worry about and is an indicator for immediate check-up”. 



Diagnosis and treatment



There are three major signs to conform the diagnosis of glaucoma,“raise of intraocular pressure, cupping of optic nerve disc (pressure mark on the optic nerve) and defect in field of vision,” mentions Dr Gautam. 



When it comes to treatment, it is not the same, so there are different types — eye drops, laser therapy and surgery. 



You may wonder, these treatments are perhaps expensive and not available in the country. Fortunately, “All the aforementioned types of treatment are available in Nepal,” assure Dr Gautam and Dr Shrestha.



The best part is still not over as “eye services in Nepal are not expensive and one doesn’t need go abroad for it”


Unfortunately, people are not aware about glaucoma. As it has no symptoms, only preventive measures that remain are “awareness programme in the community, glaucoma screening programme and proper diagnosis on time”.


- Shradha Pal, The Himalayan Times