The column is more serious than usual this week as it concerns blindness but please read on because people are going blind unnecessarily in this country and the few minutes you spend reading this piece could well save your own sight or that of somebody you love.
Glaucoma is an eye disease that can cause blindness but, if diagnosed early, it can be controlled and contained. Due to our rapidly growing ageing population, the prevalence of glaucoma is on the increase and everybody should be aware and afraid of the condition.
Glaucoma is the world’s second leading cause of blindness and currently glaucoma accounts for 12% of all blindness. The sad fact of the matter is that there are many people in Ireland today who could have been spared that disability had they gone for a routine check.
Believe it or not, twice as many people are afraid of going blind as they are of premature death or heart disease. That is according to a world-wide study of more than 4,000 people about glaucoma, the results of which were published recently to mark the first World Glaucoma Day. The research was sponsored by Pfizer and supported by the World Glaucoma Association and the World Glaucoma Patients Association.
To mark the day, Professor Colm O’Brien, Consultant Ophthalmologist at the Mater Hospital, and Ms. Aoife Doyle, Consultant Ophthalmologist at the Royal Victoria Eye and Ear Hospital, appealed to people to be aware about the disease. “Glaucoma is the name given to a number of diseases that irreversibly damage the eye’s optic nerve and can lead to progressive loss of vision if left untreated. The disease is commonly detected by measuring the pressure in the eye”, said Professor O’Brien.
In the survey, some 27% of people said they did not know what glaucoma was and nearly 40% did not know that it could cause blindness. Nearly 70% had not discussed visiting an eye doctor with their family doctor. Furthermore, 63% of people with eye problems did not discuss seeing an eye specialist with their doctor even though up to 40% of the optic nerve can be damaged before vision loss is noticed.
“The best way to tackle glaucoma is to diagnose early”, said Professor O’Brien. “The risk of getting glaucoma increases as we age. Other risk factors include having a family member with glaucoma, being short-sighted and also diabetes. All the evidence indicates that if we can diagnose a patient in the early stage of the disease, there is every likelihood that treatment will prevent progression of the disease. Most patients are well treated with eye-drops alone, though some require laser or surgery to control the eye pressure.”
Mr. Des Kenny of the NCBI said: “World Glaucoma Day was created to raise awareness of the disease and to highlight the importance of regular eye exams. As the research shows, people have a genuine fear of blindness but it is clear that they don’t take steps to look after their eyes. In 2007 alone, 76 people in Ireland registered as blind as a result of glaucoma. Glaucoma is a preventable disease and cases in Ireland should be falling, not rising.”
Research has shown that people over the age of 40 have a significant fear of going blind. Almost 72% said they believed that having glaucoma would impact their ability to drive, 64% said they might be unable to work and 56% said they would be unable to leave the house. Yet despite this, and the fear of blindness over heart disease and premature death, 27% of people did not think eye health was a priority.
A free booklet supported by Pfizer about glaucoma is available by calling the NCBI (National Council for the Blind of Ireland) on 1850 334353.
And then there is AMD
AMD is another condition that can affect your eyes as you get older. It is not as well known as other eye diseases such as cataracts or glaucoma but it is the leading cause of legal blindness for people over the age of 50 in the Western world, It is thought to affect 1 in 10 people over the age of 50 every year in Ireland.
Waterford Consultant Ophthalmologist, Mr. Stephen Beatty, points out that AMD affects the macula, a small part of the eye responsible for central vision that allows you to see detail. AMD usually starts in one eye and is highly likely to affect the other eye at a later stage.
The macula is located in the centre of the retina at the back of the eye. As you read, images are focused onto the cells of the macula. From here information is passed to the brain where it is converted into a picture of what you are seeing. This central vision allows you to read, drive, and perform other activities where recognising detail is important.
Mr. Beatty also points out that Dry AMD is the most common form of the condition and it develops slowly eventually leading to loss of central vision. Wet AMD is caused by leaky blood vessels inside the eye. It is less common than dry AMD but it can cause more rapid loss of vision.
What causes AMD?
According to Mr. Beatty, the exact causes of AMD are still unknown. However, we do know that risk for AMD increases if you have a relative with this condition, or if you smoke. Therefore, if close relatives have suffered with sight loss in the past, it may be worth getting your eyes checked more regularly.
Other factors such as high blood pressure and poor diet can also lead to a greater risk. Indeed, recent research suggests that dietary antioxidants may protect against progression of AMD. Today in Ireland, there are thousands of people with AMD. However, less than 1 in 7 of these will have wet AMD, the type of AMD that will cause rapid sight loss. The chance of getting AMD increases as you get older. However, most people develop the dry form which is currently untreatable. Wet AMD, the type that causes rapid vision loss, can in many cases be treated and sight loss limited but early diagnosis is vital. In both cases, help and support is available from low vision services.
The most obvious symptoms of AMD are distortion and blurring of central vision. People with AMD have difficulty in recognising detail and this can show itself when reading, driving and even when trying to identify a familiar face. There are three clinically proven treatment options for wet AMD patients and any person with any concerns should contact their GP or eye specialist immediately.
Ballygunner men and their dogs
Two friends from Ballygunner were avid hunters and lived for the time they spent stalking the woods and bogs with their dogs and guns. Even though they were firm friends, there was a great rivalry between them as to who had the best dog.
Joe was in the market for a new dog and, determined to get the very best animal possible, he scoured the country unbeknownst to his friend Bill. He finally hit gold in the village of Lixnaw, County Kerry, where he found a man who was reputed to have the best hunting dogs in Ireland.
“This dog comes from a very special litter and I would only sell him to a genuine hunter like yourself”, said the breeder as Joe and himself shook hands on the deal. “What is particularly special about him”, asked Joe delighted that the dog and himself immediately became friends. “Well”, said the man, “he will do all the things a good hunting dog should do and more but he can also walk on water so he can quickly retrieve any birds shot down over lakes or rivers.”
The next week, Joe and Bill were out hunting and Joe made a great show of introducing his new dog but said nothing about the animal’s special gift deciding to let Bill see for himself. They weren’t out long when the spotted a flock of ducks flying over the lake and Joe took aim and fired. A duck fell and, immediately, his new dog responded and jumped into the water. And, as the man from Kerry had promised, the dog did not swim towards its quarry but, instead, scampered across the water and was back in a jiffy with the bird in his mouth and his paws hardly wet.
On the day, Joe’s eye was in and the dog repeated the exercise several times more but even though Bill was watching everything like a hawk, he never opened his mouth to comment on Bill’s dog’s unusual gift. On the drive home, Joe couldn’t contain himself any further and, nonchalantly, he said to his friend. “Well, Bill, what do you think about my new dog?”
“Well, Joe”, said Bill with a sniff, “he looks good enough but, personally, I wouldn’t have a dog that couldn’t swim.”