India can easily be the world’s capital of glaucoma, a group of eye disorders that leads to irreversible blindness, with the disease affecting 12 million people, and remaining undiagnosed in over 90% of the cases. Increasing population of senior citizens, diabetics and people with refractive errors, the known potential risk factors, are set to make glaucoma a rapidly emerging non-communicable ocular disease in the country, which already houses 20% of the world’s blind.

No known measures to prevent glaucoma

There are no known measures to prevent glaucoma. The only way to prevent blindness from glaucoma, which shows no symptoms in the early stage, is early diagnosis and treatment that could halt the progression of this silent thief of sight. Nearly 40 million people in India, including 1.6 million children, are blind or visually impaired. Next to cataracts, and untreated refractive errors, glaucoma is the third leading cause of blindness in India. However, glaucoma is more complex and dangerous as the sight loss caused by it is progressive and, unlike cataract, is irreversible.

Glaucoma is both under-diagnosed and under-treated

Glaucoma is both under-diagnosed and under-treated. It occurs when the pressure inside the eye (Intraocular pressure) increases. The pressure is normal so long as the rate of production of aqueous humor, the clear liquid inside the front part of eyes, matches the rate of its drainage. However, when the channels carrying this fluid get blocked, the pressure inside the eye increases. This increased pressure damages the optic nerve, which passes the visual messages to the brain.

There are two major types of glaucoma: open angle glaucoma, and close angle glaucoma. Open angle glaucoma is the most common form of glaucoma. It accounts for at least 90% of all glaucoma cases. It progresses very slowly and the patient may not feel any loss of vision until it affects the central vision. This results in permanent damage if the patient does not get an eye check-up.

Dr. Bindiya Hapani
Senior Consultant Ophthalmologist
Dr Agarwal’s Eye Hospital, Koramangala.

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The ongoing pandemic has led to increased severity and morbidity in eye conditions of people in Bengaluru because of delayed treatment and lifestyle changes due to the pandemic. The elderly people have been particularly impacted, with cases of mature cataracts going up as much as five times compared to the period before the pandemic. Incidence of severe dry eyes has also risen three times as people have been spending more time glued to digital screens.

According to Dr. Ram Mirlay, Regional Head – Clinical Services, Dr. Agarwals Eye Hospital, Bengaluru: “During the last one year of the pandemic, patients have been worried about contracting coronavirus if they visited a hospital. Most people with pre-existing eye problems did not go for regular follow-ups during the lockdown and even afterwards, leading to aggravation of their condition. Others with newly developed eye problems waited to consult the doctors, which led to serious consequences, including loss of vision.

He further added-” In the last three months of 2019, before the pandemic had hit fully, just 10 percent of all cataract patients coming to our hospital were suffering from mature cataract. In the last quarter of 2020, this figure jumped to 50%, a five-fold increase. We have also noticed worsening of existing cases of glaucoma in many patients as they hesitated to come for regular follow-ups. People with diabetes ignored their period eye check-ups, leading to severe complications in their retina. Pandemic has had a huge socio-economic impact too. Many cataract patients coming to us are opting to get operated in only one eye, as they are running low on finances due to reduced income.”

Dr. Archana S, Regional Head – Clinical Services, Dr Agarwals Eye Hospital, Bengaluru says “Cases of severe dry eyes due to digital eye strain jumped from 10% before the pandemic to 30% now, as working from home led to loss of work-life balance and people got habituated to looking at digital screens for long hours. Those working on digital screens blink much less than normal, and even the blinks are not fully complete. This, coupled with glare and flickering of screens, has led to a big spike in incidence of digital eye strain and dry eyes. To give relief to the eyes, the rule is that for every 20 minutes of computer work, you should look away for 20 seconds to objects at least 20 feet away, or, better still, look out of the window.”

Says Dr. Ram Mirlay: “Diabetic patients above 50 years old need to get their eyes screened at least once a year by an ophthalmologist, as over 30% of them go on to develop some form of diabetic eye disease, including vision-threatening diabetic retinopathy. Such patients should be extra careful in the pandemic time and do not hesitate to visit a hospital for regular check-ups. Any delay can create more severe complications, including loss of vision. This is true for Glaucoma patients too. If their condition is unstable or they develop unusual symptoms such as eye pain or changes in vision, they should see the doctor immediately.”

It is important for people to not neglect their eye problems in pandemic times. To begin with, tele-consult is a good option and, in many cases, should be enough to get the right advice. Sometimes the doctor will advise to consult in person. That is the time when not doing anything can aggravate a minor eye problem to a more serious one. Rather than delaying treatment, choose an eye hospital where all safety precautions are being implemented.

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Bengaluru is a dream destination for many; however, the rising temperature and pollution seems to be taking its toll on the residents. The city is witnessing an increase in allergic conjunctivitis, a condition which can impact the vision. Allergic conjunctivitis is a condition that results in inflammation of conjunctiva in response to allergens in the environment.  Although not life threatening, people tend to neglect and attempt self medication which is dangerous.

If untreated,this eye problem can damage the cornea affecting the vision. Pain, redness, itchiness, gritty feeling and constant tearing up are the most common symptoms of allergic conjunctivitis. While medication (eye drops) is used to treat allergic conjunctivitis, some have significant side effects as well like cataract formation, glaucoma, infections of the cornea and conjunctiva which require surgical intervention.

The rising temperature, dry weather and the pollution in the environment are some of the reasons for allergic conjunctivitis. In fact, Out of the 10 patients who walk in everyday to our hospital around 4 are diagnosed with this allergic condition. However, usage of sunglasses while going out and intake of adequate amount of water can help prevent the condition. Mild steroids are prescribed to patients with allergic conjunctivitis. While the occurrence of the condition cannot be completely ruled out, following healthy habits can prevent the condition. 

Some of the tips to keep your eyes safe  are:

1. Reduce exposure to allergens by maintaining a clean and tidy surrounding.

2. Avoid sharing of cosmetics especially eye make-up and also reduce the usage of it.

3. Frequent cleaning of the eyes with clean cold water will wash away the allergens and the chemical mediators that cause itching.

4. Avoid sitting close to the AC.

5. Avoid using woollen blankets.

6. Keep pets clean and avoid any contact with the possible secretions and fur of them.

7. Avoid using carpets inside house.

8. Avoid self medication.

Dr. Amod Nayak, Medical Director
Dr. Agarwal’s Eye Hospital
Whitefield, Bengaluru

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