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You are here:Home>>Strategic Research & Analysis>>Dr. G. Stanley O’koye>>Glaucoma in Blacks
Sunday, 19 September 2010 00:19

Glaucoma in Blacks

Written by Dr. G. Stanley Okoye
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Glucoma Human Eye Glucoma Human Eye National Eye Institute

 

High Prevalence of Glaucoma among African Descents

Eye sight is undoubtedly one of most precious gifts of God that deserves complete care and attention to function to its optimum level. Early detection and timely diagnosis can help to prevent fatal eye diseases. However, if left untreated for long, some eye diseases can lead to permanent and total loss of vision. This is the reason why, physicians & eye doctors urge people to get routine eye checkups done every once in a while irrespective of whether or not they are experiencing any problems since many diseases have symptoms which are almost unnoticeable. Glaucoma is one such eye disease that should not be taken lightly.

Research has shown that African descents are genetically more inclined to developing Glaucoma and subsequent blindness than people of other ethnicities. What’s even more worrying is the fact that black patients generally show signs of glaucoma early on (about 10 years earlier than others).

In order to get timely treatment and care, it is essential for African descents to get themselves checked regularly (every one to two years) for glaucoma, especially after reaching the age of 35-40 years.

What is Glaucoma?

In simple terms, glaucoma is an eye disease that damages the optic nerve and can lead to vision impairment if not treated on time. Often, an increased and unrelieved pressure in the fluid of the eye (intraocular pressure) is also considered to a factor contributing to glaucoma. This disease can develop at any point of time, making timely diagnosis & thorough treatment very important. Specifically, a balance in the eye fluid production and drainage has to be maintained for normal eye pressure, range between 10 to 20. The front chamber (Anterior Chamber) of the eye is filled with aqueous clear fluid produced from a structure called the ciliary process at the back of the eye lens. The aqueous fluid is slowly pumped into the anterior chamber and then slowly drains out into the blood stream through the channels called the Schlem canals.  In glaucoma, there can be a problem with aqueous fluid not draining out of the eye quickly enough. The reason for such slow drainage can range from chronic eye inflammation from eye injury, increasing age, use of steroid medications, diabetes, or increase genetic susceptibility to abnormal functioning of the drainage channels. Following slow drainage of the aqueous fluid, the eye internal pressure can rise and press upon the optic nerve which is the weakest part of the eye.  This can be likened to squeezing a balloon with the neck or tip of the balloon pushed out as the eye internal pressure increases.  With African descents, it is possible that there is increase predisposition to slowing down of the drainage with time, or increase susceptibility of the optic nerve to damage by the smallest change in the eye pressure even when it seems be within the average normal range.

Figure: medicblogs.blogspot.com
There are 2 main types of Glaucoma: Primary Open-angle Glaucoma & Angle-closure Glaucoma. In blacks, the occurrence of Primary Open-angle glaucoma is more common.
Common Risks: While several factors contribute to glaucoma formation, some of the risk factors include a family history of the disease, hypertension, diabetes mellitus, and a person’s race.
Common Symptoms: Frequent headaches, faulty vision in the dark, swollen eye, eye pain with mid-dilated pupil, nausea and vomiting, among others. Glaucoma screening involves observing the optic nerve head for changes, changes in the field of vision using special equipments, and excluding thick cornea as the contributing cause of increase eye pressure. Since the symptoms of open-angle glaucoma are more difficult to ascertain, it is of primary importance for ophthalmologists to check aggressively for symptoms.
Prevalence of Glaucoma in Populations with African Ancestry
The prevalence of glaucoma begins to increase in African-ancestry populations at 40 years and rises significantly with age
(According to Glaucoma Research Foundation –NEI).
Glaucoma Treatment Plan & Target Pressure
It has been established that people of African origin are more susceptible to Glaucoma. Hence, when treating glaucoma, it is vital to take into consideration a patient’s race. Treatment usually begins with medical therapy. However, in the case where further intervention is required, surgical treatment, including laser therapy and/or glaucoma may be needed to release the built up pressure in the eye.
Even though several generalizations have been made as to which treatment has given the highest success rate based on research, what cannot be forgotten is that every patient is unique. Hence, it is imperative to take on a course of treatment that is best suited to the individual’s specific medical needs.
Considering the fact that Glaucoma is a leading cause of blindness among blacks, there is an urgent need for heath care authorities to sensitize Africans on the risks they face & the importance of timely intervention to prevent further damage.
G. Stanley Okoye, M.D., Ph.D. , Chief Medical Correspondent, Africa Political and Economic Strategic Center (Afripol) and St. Jude Medical Missions ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).

 

Last modified on Sunday, 19 September 2010 00:43

1 Comment

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