The silent killer of sight, glaucoma, is on the rise among the poor people as they are unable to afford surgery or prolonged medication expenses.
Half the population that forms the serpentine queue at the government eye hospital is likely to slip into blindness due to this problem as the disease can be cured only if detected early or would result in the patient losing vision, say doctors.
“Every month, we get as many as 150 new cases of glaucoma, but are able to conduct only 8-10 surgeries. Most of the patients are too poor to afford the drugs for treatment, which is out of reach even for the middle class,” says a doctor at the hospital.
While medicines are a more popular mode of treatment for the disease in western countries, surgeries, despite their complications, are the best option for people here,” explains Dr. Krishnaraj, an ophthalmologist, pointing out that 10 to 15 per cent of patients are not even aware that they are suffering from the disease.
As the cost of eye drops begins from `200 and above depending on the treatment many people do not have enough money to procure it as a long term medical solution.
The progress of glaucoma that affects the optic nerve, causing irreversible vision loss, can be arrested if detected early.
Wednesday, May 4, 2011
Steroid Can Cause Glaucoma
CHANDIGARH: When 25-year-old Raman was detected with glaucoma (a disease of retina that usually afflicts the elderly), ophthalmologists were surprised. After seeing his case history, it was found that to cure conjunctivitis, he overused steroids without a doctor's advice, which caused glaucoma. Of 60 to 70 cases of seasonal conjunctivitis (also known as pink eye) coming daily to city government hospitals, one-fourth show glaucoma and eye ulcers ' which eventually can cause loss of vision ' due to overuse of steroids on self-medication. Dr SK Arya, department of ophthalmology at GMCH-32, said, ''We are getting 30 to 40 patients daily and half of them are new cases. Also, most of these are severe cases that have turned into glaucoma due to steroid overuse.''
''Pollen and dust are the common causes of pink eye. On an average, 30 to 40 cases come to our out patient department daily,'' said Dr Jagat Ram, eye specialist at advanced eye centre, PG
''Pollen and dust are the common causes of pink eye. On an average, 30 to 40 cases come to our out patient department daily,'' said Dr Jagat Ram, eye specialist at advanced eye centre, PG
New way to diagnose Glaucoma
Scientists have been constantly pursuing newer tests to diagnose Glaucoma. Glaucoma is an incurable condition of the eye and if left untreated can cause blindness and once it effects the vision � this cannot be restored. It is the second leading cause of blindness in the world - according to the World Health Organization.
Recently scientists they have been combining visual field and imaging data, utilizing the anatomical arrangement of retinal ganglion cells to diagnose the condition more accurately.
In a recent study by Michael V Boland, Assistant Professor of Ophthalmology at The Wilmer Eye Institute, Baltimore, data from 1499 eyes of glaucoma suspects and 895 with confirmed glaucoma eyes was identified to be studied. All the subjects underwent standard automated perimetry and Heidelberg Retinal Tomograph (HRT) imaging. The structure function index (SFI) was defined in three steps by a new technique combining the above two tests. The data was studied to study the following:-
Recently scientists they have been combining visual field and imaging data, utilizing the anatomical arrangement of retinal ganglion cells to diagnose the condition more accurately.
In a recent study by Michael V Boland, Assistant Professor of Ophthalmology at The Wilmer Eye Institute, Baltimore, data from 1499 eyes of glaucoma suspects and 895 with confirmed glaucoma eyes was identified to be studied. All the subjects underwent standard automated perimetry and Heidelberg Retinal Tomograph (HRT) imaging. The structure function index (SFI) was defined in three steps by a new technique combining the above two tests. The data was studied to study the following:-
Glaucoma treatment breakthrough
As part of a team of Australian researchers, scientists at the Queensland Institute of Medical Research (QIMR) have discovered two new genes linked to open angle glaucoma in the only study of severe glaucoma cases in the world.
The study has been published online in the prestigious international science journal, Nature Genetics.
Dr Stuart MacGregor from QIMR’s Queensland Statistical Genetics Laboratory said this discovery will help to identify patients at the highest risk of severe glaucoma.
“It opens the pathway to developing completely new ways of treating glaucoma patients that could delay disease progression and prevent blindness,” he said.
"Open angle glaucoma, sometimes called chronic glaucoma, is the most common type of glaucoma, and tends to progress at a slow rate.
"Sufferers may not notice that they have lost vision until the disease has progressed significantly.
“We found that 18% of the population carry risk variants at these two genes, making them up to three times more likely to develop severe glaucoma than those that don’t.
” Glaucoma is the leading cause of irreversible blindness worldwide, affecting an estimated 300,000 people in Australia, half of which are currently undiagnosed."
It is the collective name for eye diseases causing irreversible loss of peripheral vision, often associated with too much pressure developing inside the eyeball.
“Although open angle glaucoma is the most common form of the disease, it is poorly understood and difficult to diagnose in its early stages,” said Dr MacGregor.
"Many cases still remain undiagnosed until irreversible loss of vision has occurred.”
Researchers from QIMR collaborated with groups from five other Australian universities on the ground-breaking study of 4,500 patients from Australia and New Zealand. Dr MacGregor emphasized the important role of twins in the research.
“The genetic information provided by the twins was used in the study as a comparison to those affected by glaucoma,” he said.
The study has been published online in the prestigious international science journal, Nature Genetics.
Dr Stuart MacGregor from QIMR’s Queensland Statistical Genetics Laboratory said this discovery will help to identify patients at the highest risk of severe glaucoma.
“It opens the pathway to developing completely new ways of treating glaucoma patients that could delay disease progression and prevent blindness,” he said.
"Open angle glaucoma, sometimes called chronic glaucoma, is the most common type of glaucoma, and tends to progress at a slow rate.
"Sufferers may not notice that they have lost vision until the disease has progressed significantly.
“We found that 18% of the population carry risk variants at these two genes, making them up to three times more likely to develop severe glaucoma than those that don’t.
” Glaucoma is the leading cause of irreversible blindness worldwide, affecting an estimated 300,000 people in Australia, half of which are currently undiagnosed."
It is the collective name for eye diseases causing irreversible loss of peripheral vision, often associated with too much pressure developing inside the eyeball.
“Although open angle glaucoma is the most common form of the disease, it is poorly understood and difficult to diagnose in its early stages,” said Dr MacGregor.
"Many cases still remain undiagnosed until irreversible loss of vision has occurred.”
Researchers from QIMR collaborated with groups from five other Australian universities on the ground-breaking study of 4,500 patients from Australia and New Zealand. Dr MacGregor emphasized the important role of twins in the research.
“The genetic information provided by the twins was used in the study as a comparison to those affected by glaucoma,” he said.
Glaucoma genes point to increased risk
Researchers say they have discovered two new genes that increase people's susceptibility to glaucoma.
The findings could lead to better screening and more effective treatments, says study leader Professor Jamie Craig from the Department of Ophthalmology at Flinders University in Adelaide.
Glaucoma is a loss of peripheral vision due to damage to the retina and optic nerve, which occurs mainly in older people, and can lead to blindness.
In a study published online this week in the journal Nature Genetics, Craig and colleagues studied the most common form of glaucoma in Australia, called "open angle glaucoma".
The disease advances very slowly and many people are not diagnosed until they start bumping into things.
"It's a bad thing if people present at that late stage because all the treatments that we have are able to slow the disease down and potentially [stop it] getting worse, but none of the treatments at this stage can bring back vision that's already lost," says Craig.
Genetic link
People with a family history have been known to have a greater risk of glaucoma, says Craig, but until now, only one gene has been linked to the disease.
A mutation in a gene called "myocilin" is believed to account for just 3 per cent of cases, he says.
Craig and colleagues studied 1500 glaucoma cases and 8500 control cases in Australia and New Zealand.
They compared the DNA of the two groups and found two common gene variants that seemed to be associated with a greater risk of glaucoma.
People who had these gene variants were three times more likely to have glaucoma than the general population, says Craig.
Craig says the association is even stronger for severe blinding glaucoma.
He estimates the genes variants could be responsible for a substantial proportion of glaucoma cases in the wider population - possibly 30 per cent.
New treatments?
Craig says the latest genetic discovery could help in the development of more effective treatments.
Current treatments, including eye drops, laser and surgery, are aimed at reducing pressure in the eye but sometimes they don't work, he says.
While glaucoma is usually associated with raised fluid pressure within the eye, 20 per cent of people with glaucoma do not have this raised pressure.
The researchers carried out tests in rats with glaucoma and found that one of the newly discovered gene variants was more active in the retina.
They believe it could be linked to death of the optic nerve, independent of pressure from fluid in the eye.
Craig says further research could show that a drug that blocks the expression of this gene could slow down the damage to the optic nerve in all cases of glaucoma.
He and colleagues are continuing to work with animal models to understand the mechanism by which the genes act to increase the risk of getting glaucoma.
Better screening
Craig says the new genetic association could also be used to identify which people are at a highest risk from glaucoma before any clear signs appear, and to help decide when treatment should be begin.
This is important, as treatment comes with costs and side-effects and is something people must take for the rest of their lives.
Craig is now involved in a study to see whether the new genetic information can be successfully used to help identify people who should be treated for glaucoma.
He advises people to have eye check-ups every two years with an optometrist or ophthalmologist after the age of 40, especially if they have a family history of glaucoma.
The study drew on the Australian and New Zealand Registry of Advanced Glaucoma, funded by The Eye Foundation, with support from Pfizer, which produces current glaucoma treatments.
The findings could lead to better screening and more effective treatments, says study leader Professor Jamie Craig from the Department of Ophthalmology at Flinders University in Adelaide.
Glaucoma is a loss of peripheral vision due to damage to the retina and optic nerve, which occurs mainly in older people, and can lead to blindness.
In a study published online this week in the journal Nature Genetics, Craig and colleagues studied the most common form of glaucoma in Australia, called "open angle glaucoma".
The disease advances very slowly and many people are not diagnosed until they start bumping into things.
"It's a bad thing if people present at that late stage because all the treatments that we have are able to slow the disease down and potentially [stop it] getting worse, but none of the treatments at this stage can bring back vision that's already lost," says Craig.
Genetic link
People with a family history have been known to have a greater risk of glaucoma, says Craig, but until now, only one gene has been linked to the disease.
A mutation in a gene called "myocilin" is believed to account for just 3 per cent of cases, he says.
Craig and colleagues studied 1500 glaucoma cases and 8500 control cases in Australia and New Zealand.
They compared the DNA of the two groups and found two common gene variants that seemed to be associated with a greater risk of glaucoma.
People who had these gene variants were three times more likely to have glaucoma than the general population, says Craig.
Craig says the association is even stronger for severe blinding glaucoma.
He estimates the genes variants could be responsible for a substantial proportion of glaucoma cases in the wider population - possibly 30 per cent.
New treatments?
Craig says the latest genetic discovery could help in the development of more effective treatments.
Current treatments, including eye drops, laser and surgery, are aimed at reducing pressure in the eye but sometimes they don't work, he says.
While glaucoma is usually associated with raised fluid pressure within the eye, 20 per cent of people with glaucoma do not have this raised pressure.
The researchers carried out tests in rats with glaucoma and found that one of the newly discovered gene variants was more active in the retina.
They believe it could be linked to death of the optic nerve, independent of pressure from fluid in the eye.
Craig says further research could show that a drug that blocks the expression of this gene could slow down the damage to the optic nerve in all cases of glaucoma.
He and colleagues are continuing to work with animal models to understand the mechanism by which the genes act to increase the risk of getting glaucoma.
Better screening
Craig says the new genetic association could also be used to identify which people are at a highest risk from glaucoma before any clear signs appear, and to help decide when treatment should be begin.
This is important, as treatment comes with costs and side-effects and is something people must take for the rest of their lives.
Craig is now involved in a study to see whether the new genetic information can be successfully used to help identify people who should be treated for glaucoma.
He advises people to have eye check-ups every two years with an optometrist or ophthalmologist after the age of 40, especially if they have a family history of glaucoma.
The study drew on the Australian and New Zealand Registry of Advanced Glaucoma, funded by The Eye Foundation, with support from Pfizer, which produces current glaucoma treatments.
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