Kathmandu Glaucoma, the second leading cause of blindness, is a group of eye diseases where there is damage of the optic nerve. In most of the cases, glaucoma is related with pressure inside the eye. Whenever there is an increase in the eye pressure, there are chances for one to suffer from glaucoma. And if left untreated or timely treatment isn’t done, it leads to loss of vision in patients. Open and Closed angle glaucoma Glaucoma is of two types — open angle glaucoma and closed angle glaucoma. There is an acute and sudden pain in eye(s) in closed angle glaucoma. Mass loss of vision, painful eye(s), and redness in eye(s) are some of the symptoms in closed angle glaucoma. In addition, nausea and vomiting too can be experienced. On the contrary, there is no such pain or redness in the open angle glaucoma and in most cases there aren’t early symptoms visible. The optic nerve then slowly and gradually starts to get damaged. “As there aren’t any symptoms in most of the cases of open angle glaucoma, patients don’t even know that they are suffering from the disease,” explains Dr Shailesh Mani Pokharel, Assistant Professor, Department of Ophthalmology, BP Koirala Institute of Health Sciences, Dharan. “As there is no such symptom in open angle glaucoma, when patients come to the OPD, the disease is usually identified,” he adds. But for those who don’t come to the hospitals, it is difficult to identify the disease. “And when a patient comes in the late stage of the disease, there is loss of vision. This is why timely treatment of the disease is very necessary,” suggests Dr Pokharel about glaucoma. Causes The cause for glaucoma is due to an increase in eye pressure. It usually occurs when intraocular pressure (IOP) increases in the eye(s). This intraocular pressure is the fluid pressure inside the eye and high IOP indicates a problem with aqueous humor — liquid present in eye. “The liquid is either produced in excess or it is not drained properly,” informs Dr Pokharel. “People often come complaining with loss of peripheral vision,” adds the doctor. If it is left untreated, there will be complete loss of vision. Anyone can suffer from the disease. But those with a family history of glaucoma are more likely to suffer from the disease. That is why people with family history of glaucoma should be aware. Diabetics and patients of myopia — refractive error, cardiac patients are also under high risk of glaucoma. In addition, people above the age of 40 are prone to the disease, as per him. Furthermore, those taking steroids for a long time are also under risk of suffering from glaucoma. “This is why such people must be very conscious,” suggests Dr Pokharel. Condition in the country People aren’t much aware about glaucoma and its effects. Besides that many do not have easy access to eye health services. “Patients come here complaining of decreasing vision. They often complain of peripheral loss of vision. Upon examining and screening them, glaucoma is identified,” informs the doctor.  To identify the disease and to prevent loss of vision, several eye camps are organised in and around the country, as per Dr Pokharel. Though the disease can be identified upon screening, it is difficult to bring the damaged optic nerves to the previous undamaged condition. “We can only prevent the optic nerves from further deterioration. We are able to control eye pressure through available treatment services. Though there are multiple anti-glaucoma medication available in pharmacies, one must use such medicines only under the prescription of an ophthalmologist. The treatment services are available in eye hospitals in the country. So as to prevent the loss of vision one must visit the ophthalmologist regularly. Diabetic patients are suggested to visit at least once in six months because they are prone to diabetic retinopathy,” he adds.