Delay in detection causing rise in Glaucoma-related blindness in India

Dr Shibi Dev BN

Glaucoma-related blindness is continuing to rise in India due lack of awareness & delay in detection. Glaucoma is a very common eye disease characterised by damage to the optic nerves due to high eye pressure, affects nearly 12 million people in India. Statistically, over 90 per cent of glaucoma cases in the country go undetected, leading to irreversible blindness each year.
A majority of glaucoma cases either go undiagnosed or are detected till advanced stage, as it doesn’t show symptoms and patients are unaware of the progressive damage to their optic nerve making the blindness irreversible at this point. Managing glaucoma in India comes with many critical challenges, including low awareness levels, undetected and undiagnosed cases, limited access to diagnostic and therapeutic services, and issues with treatment compliance. We have seen through various academic studies and research that glaucoma causes blindness in 1.5 million individuals, representing 5.5 per cent of total blindness cases in India, making it the primary cause of irreversible blindness in the country. When patients begin to notice signs and symptoms of glaucoma, the disease has often already caused irreversible damage. Once vision is compromised due to the unhinged progress of the disease, it cannot be restored. Glaucoma, while chronic and currently incurable, can be managed and its progression slowed with medical and surgical intervention if detected early.
Individuals particularly over 40 years, positive family history of Glaucoma, history of eye injury, inadvertent use of steroid medicines are at high risk. With one in 20 Indians over 40, either getting affected by glaucoma or at risk of developing it. However, Glaucoma can affect people even without any risk factor but at a lower rate.

Treatment
The first line of treatment for glaucoma management is to lower the intraocular pressure responsible for optic nerve damage. There are eye drops specifically designed to reduce eye pressure by better drainage of fluid from the eyes or reduce the production of fluids in the eye. Laser procedures are also available for reduction of Intraocular pressure. Other than these the most common mode of treatment is surgery. Minimally Invasive Glaucoma Surgery or MIGS is the modern alternative to traditional trabeculectomy where the MIGS implant is inserted during phacoemulsification (Cataract) surgery, reducing the need for topical medications. It has a high success rate in lowering IOP (intraocular pressure) with minimal risk of complications in certain types of Glaucoma. MIGS ensures minimal tissue trauma and faster recovery for the patient.
There is a pressing need for increased public awareness, regular eye check-ups, and access to affordable and accessible treatment. We urge the government and international organizations to collaborate in addressing glaucoma as a public health issue, ensuring effective prevention, screening, and treatment services for all individuals.
To reduce the disease burden, there has to come a major mindset change towards glaucoma management. Though it is a leading cause of blindness in the country, there isn’t much awareness about the disease making it easily unnoticeable.

Creating awareness 
Regular eye check-ups are an essential part of glaucoma management. It is also important to educate patients about the long-term nature of glaucoma management and the benefits of consistent use of eye drops which will enhance treatment effectiveness. Launching campaigns and eye screenings are vital for increasing public awareness of glaucoma, its symptoms, and the significance of regular eye examinations.

Dr Shibi Dev BN, Head of Department, Glaucoma,
Nethradhama Super Speciality Hospital