STRESSED TO THE EYEBALLS: IT CAN RUIN YOUR SIGHT
Once you hit 40, the phrase ‘stressed to the eyeballs’ can take on a whole new meaning. It is from this age that people become susceptible to a common condition that quietly puts their eyes under stress. Left untreated, it can cause a devastating deterioration in their vision over time.
The condition, which cannot be detected by others, used to be called ‘tunnel vision’ but today it is largely referred to by its medical name, glaucoma.
It causes a silent build-up of pressure inside the eye which gradually leads to a loss in side vision. It is not until people start bumping into things, driving dangerously or losing accuracy in physical tasks, that they realize something has been lost.
Take the case of a 45-year-old plumber who only realised his peripheral vision was shot when he nearly brained a mate on a job. To gain increased downward thrust, the plumber lifted a tool above his shoulder. He had not noticed his unfortunate mate standing slightly behind and to the side of him. Because his central vision was perfect, he had relied on it and been unaware of the narrowing of his field of vision. This is typical. People rarely notice the loss of field, and it is for this reason that glaucoma is known as ‘the sneak thief of sight’.
The specialist who treated this plumber says glaucoma had damaged almost 90 per cent of his optic nerves. The damage was irreversible and difficult to contain. Had it been detected earlier, it could have been arrested with treatment, saving the man from becoming so visually handicapped that he needed a blind pension.
The only way to protect himself would have been to have had regular check-ups. Past the age of 40, people should generally have their eyes checked every 3 to 4 years. But if they know they are at risk, they should be checked earlier. Glaucoma tends to run in families, and those with hereditary glaucoma tend to develop it at about the same time as other members of the family have developed it.
Those most at risk include people who:
have a blood relative with glaucoma
have diabetes or a relative with diabetes
are short-sighted
have had injury to the eye, even many years ago
have high blood pressure
are using steroids anywhere in the body.
Of the estimated 360 000 Australians who have glaucoma, most would have developed it within their working lives.
There are different kinds of glaucoma. Childhood glaucoma is usually inherited and if undetected can lead to blindness, as it did in the case of the musician Ray Charles. By the age of 6 he had lost all sight.
The most common form, known as primary open-angle, or chronic, glaucoma, is painless and silent. Once diagnosed, it is this form that successful men try to hide. While a man will unashamedly hobble into a board meeting on crutches after having a hip replacement, he would never admit to glaucoma. There is an irrational fear that somehow it will impact on his cognitive function or decision-making ability. There is also a view that it is mildly disgraceful. Cognisant of this stigma, US president Bush announced during his term of office that he had the condition. Although it usually occurs in both eyes, he only had it in one eye at the time.
Glaucoma is the result of a defect in the internal drainage system of the eye that causes pressure to build in the eye itself. This squeezes the blood vessels supplying the optic nerves. Gradually, nerve fibres die. Some take a couple of years to die, while others take a couple of decades. As they die, peripheral vision is gradually lost. If the process is not halted, it will eventually kill off central vision too.
Treatment can be very effective and usually involves administering eye drops daily. If the condition is bad, lasers may be appropriate. In severe cases surgery is used to create an artificial drainage system.
In Australia people tend to confuse glaucoma with trachoma, an eye infection endemic in hot, dry, poverty-ridden parts of the country where there is little sanitation or fresh water.
Trachoma is a completely different condition and unlikely to be found in the sophisticated environment of urban Australia, where glaucoma flourishes.
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