Restoring the program of early detection of glaucoma would save many people from blindness and reduce costs of treatment, said the participants of the press conference held in Warsaw on the occasion of World Glaucoma Day.
Glaucoma can be considered a chronic social disease – worldwide, it causes blindness to millions of people, and about 70 million suffer from it. Due to the aging of societies, this number will increase to 10 million in 80 years – said Prof. Jerzy Szaflik, national consultant in the field of ophthalmology.
World Glaucoma Day is a joint initiative of the World Glaucoma Association (WGA) and the World Glaucoma Patient Association (WGPA) to encourage action to prevent vision loss.
Glaucoma is a disease of the optic nerve – if left untreated, it leads to its atrophy and vision loss – explained Prof. Dishpan. The most common cause is abnormally high pressure inside the eyeball. Glaucoma develops quickly and usually asymptomatically – it is not painful, and the loss of the visual field is slow, often imperceptible (a healthy eye can compensate for the impaired vision in the affected eye). Some people only see a doctor when they can see only one eye.
According to specialists, there may be from 380 to even 800 patients in Poland, of which only about 65 know about their disease and receive treatment. Others slowly lose their eyesight, not realizing they are sick. According to the data of the Polish Association of the Blind, 18-20 percent of blind people in Poland have lost their eyesight due to glaucoma. The risk of developing the disease increases with age, especially after the age of 45, glaucoma is also associated with its family history, hypertension or low blood pressure and myopia.
Glaucoma detected early can be treated – modern drugs as well as laser and surgical treatment are available. However, early detection is most important – treatment will not restore the patient’s normal vision, it can only stop the development of the disease, and untreated glaucoma will inevitably lead to complete, irreversible blindness. Therefore, at each visit to an ophthalmologist, he should assess the fundus of the eye and the optic nerve – said Prof. Dishpan. Devices (tonometers) are very well suited for screening tests, measuring the pressure inside the eye without contact – based on the deflection of the cornea under the influence of a light blast. They can be handled by non-specialists, and the abnormal results allow the patient to be referred for more detailed examinations.
In the treatment of glaucoma, among others, beta-blockers, carbonic anhydrase inhibitors, preparations acting on adrenergic receptors and prostaglandins are used – said Prof. Marta Misiuk-Hojło from the Medical Academy in Wrocław. Prostaglandins have an interesting side effect – they cause the iris to darken and the eyelashes to lengthen and become darker. A gel for eyelash growth that takes advantage of this effect has already appeared in the USA. As Dr. Ewa Langwińska-Wośko said, while the patients never complained about eyelashes that were too long, men sometimes shortened them with scissors, especially when the glaucoma concerned only one eye.
As shown by the Australian research cited by Dr. Langwińska-Wośko, the fewer drugs and the simpler their dosage, the greater the effectiveness of treatment – hence, preparations combining several drugs are becoming more and more popular. It is easier to instill one preparation several times into the eye every day than three different preparations (especially as after introducing one preparation into the eye, you need to wait 5 minutes for it to be absorbed and not rinsed onto the cheek). In Poland, as many as 12 percent of surveyed patients taking medication for glaucoma said they did not know why they were taking it – in this group the most common medications were taken incorrectly and too rarely. The better the education and awareness of the patient, the better the chances of a successful treatment – but the doctor should also give precise and understandable directions about taking medications.
In Poland, under contracts with the National Health Fund, in 2007 a program of early diagnosis of glaucoma, monitoring of the disease progress and its effective treatment was implemented for people over 35 years of age. Unfortunately, it was not accepted for the following years, despite the fact that, according to the calculations of specialists, it would bring financial savings – treatment of late-diagnosed glaucoma is more expensive, not to mention saving many people from suffering from blindness – said Prof. Szaflik. (PAP)