GLAUCOMA is an eye disease that damages the optic nerve, which sends images to the brain. The damage is caused by increased pressure in the eye.
It causes vision loss or blindness if not attended to on time. It constricts the visual field, and the mild forms cause problems in reading and navigating around, increasing the risk of falling.
The symptoms start slowly and may not be noticed, that is why most people with glaucoma do not know they have it. There is no treatment for glaucoma, but early treatment can stop the damage and save vision. This is why regular eye examinations are crucial for detection.
The World Report on Vision (2019) estimates 64 million people globally have glaucoma, which leads to severe visual impairment and blindness.
It is a common age-related eye condition in Africa. The Zimbabwe National Eye Health Strategy (2021-2025) confirms glaucoma as another cause of severe and irreversible blindness.
The prevalence rate is 20% for glaucoma in Zimbabwe for people aged 50 years and above. Anyone can get glaucoma. However, some people are at higher risk, and this includes the aged, especially those above 60 years, people with a family history of glaucoma and individuals with medical conditions, such as diabetes or high blood pressure, among others.
The most common type of treatment is eye drops, which must be applied every day to lower the pressure in the eye and prevent further damage to the optic nerve.
Alternatively, health professionals can use laser treatment to lower the pressure in the eye. If the laser treatment and eye drops do not work, surgery can be another option.
The medical interventions will delay or prevent progression of the eye condition. If vision is lost it cannot be restored. However, lowering the eye pressure can help to keep the sight. Having worked in facilitating eye health interventions for years, I witnessed the restoration of eyesight and life changing experiences when a person, whose blindness was caused by a cataract, underwent surgery to have their sight restored.
For some, their joy was short-lived, after being diagnosed with glaucoma. They are told the devastating news that the blindness is irreversible.
In glaucoma cases, by the time one starts losing their vision, the damage would already be severe. Like a thief, glaucoma takes away the sight, never to be restored. The biggest challenge is that many people are living with glaucoma and have not been diagnosed and are not receiving treatment.
Challenges
Loss of vision makes it difficult to move around, especially in unfamiliar environments. Dealing with vision loss and managing glaucoma can lead to frustration, depression, anxiety, and individuals become dependent on others for daily living activities.
Individuals with glaucoma may face stigma and discrimination due to misconceptions and assumptions about their capabilities.
Glaucoma eye drops are not only expensive but are also difficult to adhere to for patients, who are on other medication for chronic illnesses.
The cost of glaucoma medication may pause a financial burden, especially for those in rural areas, who have no health insurance coverage.
In some cases, patients face barriers in accessing eye-care services due to the high cost of patient out-of-pocket payments.
Several patients experience denial and fear. Some give up and refuse treatment.
Research suggests that loss of vision associated with glaucoma may impact the cognitive functioning. It can also contribute to the cognitive decline for older patients, further exacerbating their mental health.
It is challenging for an individual with glaucoma to perform tasks that require good vision, such as reading, using computers, and operating machinery.
Thus, vision impairment due to glaucoma can lead to reduced productivity in the workplace, as individuals take longer to perform tasks or make errors that require provision of reasonable accommodation for assistance.
Recommendations
Glaucoma is asymptomatic during the early stages and some patients underestimate the importance of treatment and regular follow-up.
Therefore, health promotion initiatives should target early detection and promote the importance of regular eye examinations.
Managing glaucoma requires regular monitoring, treatment adherence, lifestyle adjustments, which can be stressful due to financial strain and concerns about the disease progression.
Therefore, establishing community support programmes for peer networks and patient education will provide emotional support and practical guidance to individuals with glaucoma and their families.
Government should ensure access to affordable and comprehensive eye care services; this entails providing diagnostic tools for glaucoma screening and management, including training the eye health professionals.
Patient education and the need to increase access to eye care services become imperative. Subsidies or financial assistance should be provided to ensure treatment accessibility and medication affordability for glaucoma patients.
The integration of the primary eye care into primary health care systems is essential in facilitating early detection, diagnosis, and management, and will promote the continuity of care for patients.
Glaucoma is a chronic condition that requires ongoing monitoring and management to prevent vision loss. Primary health care facilities are often more accessible to patients, especially the underserved communities or rural areas where access to specialised services is limited.
Research is required to understand the underlying causes of glaucoma. There is also a need to develop cost-effective and contextual management strategies.
Therefore, resources should be allocated for research to improve patient outcomes and quality of life.
Facilitating rehabilitation programmes will assist people with glaucoma to make the most of their remaining vision by adopting strategies to support daily living.
Optimising rehabilitation will offer education and equip patients with the skills and tools to maintain their independence.
Further, it is important to enact policies and legislation that promote equal opportunities for employees with vision impairment caused by glaucoma and ensure access to assistive technologies. For example, screen readers, magnification devices and modified workstations.
Establishing integrated eye-care centres brings together different specialists and health care providers under one roof, streamlining patient care and improving accessibility. The National Eye Health Strategy has prioritised the need for glaucoma prevention, early detection, and management.
- Tigere is a development practitioner. These weekly New Horizon articles, published in the Zimbabwe Independent, are coordinated by Lovemore Kadenge, an independent consultant, managing consultant of Zawale Consultants (Pvt) Ltd, past president of the Zimbabwe Economics Society and past president of the Chartered Governance & Accountancy Institute in Zimbabwe (CGI Zimbabwe). — kadenge.zes@gmail.com or mobile: +263 772 382 852
