WORLD GLAUCOMA WEEK 2014

WORLD GLAUCOMA WEEK (9TH - 15TH MARCH 2014)

As part of the activities to mark WGW 2014, Maxivision Eye Hospital and Exxon Mobil organized a glaucoma screening program for a community in Abak, Akwa-Ibom State. A total of 261 people were screened.

Glaucoma is a group of eye disorders that have few symptoms in their early stages, but eventually leads to damage of the optic nerve (the bundle of nerve fibers that carries information from the eye to the brain) which can lead to vision loss or complete blindness.

Glaucoma is the second leading cause of blindness worldwide and affects over 60 million people worldwide.

FOUR KEY FACTS ABOUT GLAUCOMA
1. Glaucoma is a leading cause of blindness
Glaucoma can cause blindness if it's left untreated and unfortunately approximately10% of people who receive proper treatment still experience vision loss.

2. There is no cure (yet) for glaucoma
Glaucoma is not curable and vision lost cannot be regained. With medication and/or surgery, it is possible to halt further loss of vision.

3. Everyone is at risk for glaucoma
Everyone is at risk for glaucoma, from babies to senior citizens. Older people are at a higher risk for glaucoma but babies can be born with glaucoma.

4. There may be no symptoms to warn you
With Open Angle Glaucoma, the most common form, there are virtually no symptoms. Usually, no pain is associated with increased eye pressure. Vision loss begins with peripheral or side vision.

Regular eye exams are needed for a proper diagnosis and to prevent damage to the optic nerves.

Treatment for glaucoma include, medications, usually eye drops to help eye fluid drain more effectively or lessen fluid production, laser surgery or conventional surgery.
                                                                                         (Courtesy Glaucoma Research Foundation)

WORLD SIGHT DAY 2013

The theme for WSD 2013 is "Get your Eyes Tested". It's a simple and powerful call to action urging end users to get their eyes tested.

GET YOUR EYES TESTED

An eye test is the first point of contact and the first step for diagnosis and treatment for practically every eye condition.

Routine eye exams are important regardless of your age or physical health. During a routine eye exam, your eye doctor does more than just determining your prescription for glasses, he/she will also check for signs of other conditions like diabetes, hypertension, raised cholesterol levels etc.

Eye exams for children play an important role in ensuring normal vision development and academic achievement of all kids. Vision is closely linked to the learning process. Children with undetected vision problems will not complain simply because they don’t know what normal vision looks like.

Most eye conditions if detected early can be managed effectively and blindness/low vision (a dire consequence of eye disease) prevented.

Blindness and low vision have dire effects on individuals, families and communities. These effects range from a decrease in quality of life and increased mortality to large scale economic consequences. Culturally, there is often a stigma associated with blindness, further alienating the afflicted from their communities (1).

The impact of blindness and poor vision on quality of life is particularly alarming for those living in poverty. Approximately forty five million people in the world are blind, and 87% of visually impaired people live in developing countries (2). The economic consequences of blindness are staggering, as 90% of blind individuals cannot work (4). Thus, poverty and blindness are believed to be intimately linked, with poverty predisposing to blindness, and blindness exacerbating poverty by limiting employment opportunities, or by incurring treatment costs.

Blindness also affects family and community members. Approximately 75% of visually impaired people require assistance with everyday tasks (5). Blind individuals and the household members who care for them struggle with reduced earning potential and a decrease in productivity (6).

Try walking around your home blindfolded for twenty minutes, you will realize how difficult it is to carry some simple activities.

Overall, two out of three Nigerians are blind from causes which could be avoided.

Come on, go get your eyes tested.

 

World Glaucoma Week- Facts on the Silent Thief of Sight

Many of us see visually impaired people and think most of them must have been cursed. We think, who has he/she offended. These things happen, but many of them are actually victims of the silent thief of sight.
Today is day 5 of World Glaucoma Week and I just thought I should share some facts about glaucoma.
Glaucoma is a very misunderstood disease. It is regarded as the 'silent thief of sight' and often people don't realize the severity and who is affected.
Facts about Glaucoma
1) The term 'glaucoma' covers several different conditions.
~Chronic Primary Open Angle Glaucoma: this form usually affects both eyes and develops slowly so that loss of sight is gradual.
~Acute Angle Closure Glaucoma, there is a sudden increase in the pressure within one eye. The eye becomes red and painful. Often there is cloudiness of vision.
~Sometimes, other diseases of the eye cause a rise in pressure within the eye. This is called Secondary Glaucoma.
2) Glaucoma is a leading cause of blindness.
Worldwide estimates put total number of suspected cases of glaucoma at over 60 million. It is also the second leading cause of blindness according to the WHO.
It can cause blindness if left untreated and unfortunately approximately 10% of people with glaucoma who receive proper treatment still experience loss of vision.
3)There is no cure (yet) for glaucoma
Glaucoma is currently not curable but you will not go blind if your glaucoma is diagnosed early enough and you follow your treatment as instructed. However, any vision lost cannot be regained.
4)Everyone is at risk for glaucoma
From babies to adults but older people are at a higher risk. Other high risk groups include, family members of those already diagnosed,diabetics,people who are severely near sighted and people of african descent.
In conclusion, there may be no symptoms to warn you especially with open angle glaucoma which is the most common form. Vision loss begins with peripheral or side vision. You may compensate for this unconsciously by turning your head to the side and may not notice anything until significant vision is lost.
Diagnosis is the first step to preserving your vision and the aim of treatment is to lower pressure within the eye and prevent further damage to the optic nerve and vision loss. Because treatment can only control, not cure, the condition, it must be continued throughout life.
Book an appointment today with your eye care specialist.




* Sources: Glaucoma Research Foundation
                  Moorfields eye hospital NHS Foundation Trust

CARING FOR THE KING OF SENSES

CARING FOR THE KING OF SENSES

Of the five senses (hearing, touch, smell, taste and sight), sight or vision is regarded as the king of all. It’s the window of life and among the most highly specialised and sensitive organ of the body.

To enable you to see, light rays must pass through the cornea (the front of the eye), pupil (the black hole) and lens to be focused on your retina (at the back of your eye).

Many people have otherwise healthy eyes, apart from refractive errors (long sightedness, short sightedness, astigmatism) that develop in childhood. These refractive errors can readily be diagnosed during routine eye tests and can usually be corrected wearing glasses/contact lenses. In addition, ageing can also affect your eyes, making it progressively more difficult for you to read tiny prints (presbyopia - which can also be corrected with glasses).

Regular eye examinations should be part of your normal health regime from childhood because a simple eye test can pick up eye conditions like glaucoma, cataract, macular degeneration etc. If detected early enough, these conditions can be treated and managed effectively before complications such as sight loss can develop. It could also detect the signs of other conditions including diabetes, hypertension, raised cholesterol etc.

According to World health Organisation (WHO) estimates:

-          About 285 million people are visually impaired worldwide

-          39 million are blind

-          246 million have low vision (severe/moderate visual impairment)

-          Preventable causes are as high as 80% of the total global visual impairment burden

-          About 90% of the worlds visually impaired people live in developing countries

-          Globally, uncorrected refractive errors are the main cause of visual impairment

-          Cataracts are the leading the cause of blindness

The Nigerian national survey on blindness and low vision estimates that approximately one million adult Nigerians are blind and three million people are visually impaired. Eighty one percent of blindness is among adult about fifty years or more.

Poverty works with illiteracy and ignorance to cause disease and blindness. Overall, two out of three Nigerians are blind from causes which could be avoided. It is therefore a sensible precaution to have eye examinations regularly.

World Sight day is an annual day of awareness to focus global attention on blindness, visual impairment and rehabilitation of the visually impaired.

MY VISIT TO MOORFIELDS EYE HOSPITAL LOW VISION CLINIC

I was in the UK on a visit to attend my best friends wedding and what better opportunity to visit the largest eye hospital in Europe. My guide was Michael Crossland (Phd, MCOptom FAAO, Specialist Optometrist). This was actually my first time of meeting him, he came across as a very honest and hardworking fellow. The piece reproduced below was written by Michael for the 'MAGNIFIER' newsletter produced by the Low Vision foundation.

Moorfields Eye Hospital is a government funded specialist ophthalmology hospital in London, England.  It is the largest eye hospital in Europe, and Moorfields also runs smaller outreach clinics around London and South East England.

The low vision clinic at Moorfields Eye Hospital was established in 1969.  Since then, more than 100,000 low vision appointments have been made, and the clinic has grown to be one of the world’s largest low vision centres.¹  Most patients are referred into the low vision clinic by ophthalmologists working in other clinics in Moorfields.  Smaller numbers of patients are referred in from doctors in other fields such as neurology or gerontology, from other hospital eye departments without low vision facilities, and from general medical practitioners.  

Each person attending the low vision clinic is assessed by an optometrist.  The optometrist will take a detailed visual history, will measure the visual acuity for distance and near and will perform a full refraction.   Further magnification is demonstrated in the form of high addition reading spectacles, hand magnifiers, stand magnifiers, and telescopes.  Useful optical devices are issued on a “permanent loan” at no cost to the patient.  The cost of optical magnifiers and high power reading spectacles is met by the National Health Service.  Finally the optometrist will give advice about lighting, glare control, non-optical and electronic aids.    Electronic magnifiers such as closed circuit television systems are not provided by the hospital but in some cases other government agencies fund these (for example, for people in employment or education).

The hospital also employs an Eye Clinic Liaison Officer.  She can refer patients to local social service departments or charitable organisations and provides detailed advice about employment, legal protection of people with visual impairment, and state benefits.  She can also refer people for psychological counselling if needed.  For children with visual impairment, the hospital employs specialist Family Support Workers to provide advice to children and their families.  They will also liaise with schools and education authorities.

In a recent research study we have shown that our one-hour low vision appointment reduces self-reported difficulty on visual tasks by the same amount as a medical treatment which improves visual acuity by more than 5 lines (0.55 logMAR).²  Research from similar clinics has shown significant improvements in reading speed (from 20 to 72 words per minute)³ and in the ability to read  newsprint (from 22% of people before the low vision clinic appointment to 88% afterwards).⁴

In summary, the low vision clinic is an integral part of Moorfields Eye Hospital.  Ophthalmologists from all subspecialties refer patients in to the clinic.  A single one-hour low vision appointment improves the likelihood that people can read, and can improve vision-related quality of life for people with visual impairment.

1. Crossland, M. D. and J. Silver (2005). "Thirty years in an urban low vision clinic: Changes in prescribing habits of low vision practitioners." Optometry and vision science 82: 617-622.

2. Pearce, E., M. D. Crossland, et al. (2011). "The efficacy of low vision device training in a hospital based low vision clinic." British Journal of Ophthalmology 95: 105-8.

3. Nguyen, N. X., M. Weismann, et al. (2009). "Improvement of reading speed after providing of low vision aids in patients with age-related macular degeneration." Acta Ophthalmol 87(8): 849-53.

4. Margrain, T. H. (2000). "Helping blind and partially sighted people to read: the effectiveness of low vision aids." Br J Ophthalmol 84(8): 919-21.

WORLD SIGHT DAY AND CARE OF THE VISUALLY IMPAIRED IN NIGERIA

  WORLD SIGHT DAY AND CARE OF THE VISUALLY IMPAIRED IN NIGERIA  

As  the  world  celebrates  the  World  Sight  Day,  let  us  spare  a  few  thoughts  on  the  visually  impaired  and  persons  living with  low  vision (partially sighted) in  our  country,  Nigeria.  The  following  illustration  culled  from  the  Community  Eye  Health  Journal(Vol. 21 issue 66)  paints  an  ideal  picture  of  what  obtains  in  most  eye  clinics  and  hospitals  in  Nigeria:

“Mary K, a sixty-five year old widow, had been gradually losing her sight over the past five years. Looking after her three grandchildren had become increasingly difficult. Recently, her neighbour told her about the eye hospital 100km away; the neighbour had heard of older people who came back from the hospital able to see again.

After much convincing, Mary made plans to go to the eye hospital. She sold three bags of maize and gave her radio to the taxi driver so that he would take her to the hospital. The grandchildren cried when they saw her leave but her neighbour agreed to look after them for a few days. All this was worth it; after all she would come back able to see again.

Mary was sick in the taxi and the road took its toll on her old aching body, but she did not mind because the eye doctor would make her see again. After two hours of waiting in the queue at the eye clinic, Mary was seen by the eye doctor. She was very excited. Dr N examined her eyes and after what seemed like forever, he told her that she should go back to the village. He was sorry, but there was nothing he could do for her eyes. Mary protested and told him what her neighbour had said, but he just repeated the same words. “I am sorry, there is nothing I can do for you” Mary walked out of the eye clinic, wondering what to do. No one could help her and no one seemed to care.

Unfortunately, in many parts of the world, the above scenario is all too common in eye clinics. Faced with patients like Mary, eye care practitioners often feel uncomfortable and do not know what to say. Too often therefore, these patients are turned away when in fact much can be done to help them. Patients like Mary who are not completely blind, but whose sight cannot be improved either by treatment (such as cataract surgery) or by the provision of ordinary near or distance spectacles can benefit from low vision assessment and rehabilitation. Sadly, this component of eye care is underdeveloped or completely missing in our eye care system.

The World Health Organisation (WHO) fact sheet on visual impairment (Fact Sheet No 282: updated April 2011) has the following facts:

-         80% of all visual impairment can be avoided or cured

-         About 284 million people are visually impaired worldwide: 39 million are blind and 245 million have low vision

-         About 90% of the world’s visually impaired people live in developing countries

-         Globally, uncorrected refractive errors are the main cause of visual impairment but in middle and low income countries cataracts remains the leading cause

-         The number of people visually impaired from infectious diseases has greatly reduced in the last 20 years.

In Nigeria, the National Survey of blindness and low vision estimates that there are 1 million blind Nigerians and 3 million living with low vision. Thus, the majority of visually impaired people have significant residual vision and most may benefit from low vision rehabilitation.

 VISION 2020, the Right to Sight, a World Health Organisation (WHO) initiative has provided a new impetus to the concept of comprehensive eye care encompassing eye health promotion and prevention of blindness, treatment of eye diseases and rehabilitation services for people with incurable eye conditions. The hitherto underdeveloped component of low vision, along with services for refractive error, has been identified as priority area for intervention. In view of the VISION 2020 initiative, rehabilitation of low vision patients is now being given attention in different parts of the world and Nigeria must not be left out.

From the earlier illustration, perhaps all that Mary actually needed to go home happy was to be told why her vision could not be restored and that a rehabilitation worker would make a home visit. This person would have demonstrated to Mary what adaptations could be made to her home, allowing her to make the best use of her vision. Mary could also have been helped if someone had informed her of any social welfare benefits she would be entitled to.

If Mary needed to see things near to her, she may have benefitted from getting a simple magnifier to help her take stones out of rice or read (if she where literate). However, being reassured that she would not go completely blind and that help was available is perhaps the greatest service Mary could have received.

In conclusion, we need to act now by including low vision and rehabilitation services in existing eye care systems; create awareness amongst all medical, social, and rehabilitation services to ensure that patients like Mary are not sent home without any promise of help, because tomorrow that person with low vision could be you.

Dr Ogbonna Obiora is an Optometrist at Maxivision Eye Hospital and the of Low Vision Foundation. mainobiora@yahoo.com