Cure Article_Normal vision_September 2022_FB

If I have normal vision and no symptoms, do I still need to see an eye specialist?

By: Dr Nicky Cockburn , Ophtamlic Surgeon

Yes, definitely.  Because of glaucoma, the “silent thief of sight”

Glaucoma is an eye disease that permanently damages the optic nerve (the nerve at the back of the eye that takes the “picture” from the eye to the brain.)

From a certain age it is worthwhile to regularly consult an eye specialist (ophthalmologist) in order to detect glaucoma early, before it causes blindness. The main risk factors for glaucoma are advanced age, someone in your family with glaucoma, raised eye pressure, black ethnicity, short sightedness and type 2 diabetes. 

There are no widely accepted rules for when the first check up should happen.  But a rule of thumb is around the time you start to need reading glasses (mid to late 40s). If you are at increased risk, your first examination should be earlier. Initially the check ups can be infrequent, but as one ages and the risk of glaucoma increases, the  check ups should be more frequent. 

There are several good reasons (see below) why it is important to be screened for glaucoma.

1)  Glaucoma is very common. The 4 main causes of blindness worldwide are glaucoma, cataract (clouding of the lens), macular degeneration (age related degeneration of the most important part of the retina) and retinal damage from diabetes. 

2)  Loss of vision from glaucoma is irreversible. No treatment or operation will reverse the damage to the optic nerve that has already occurred or restore vision if it has been lost.

3)  There is very effective treatment available. The aim of treatment is to prevent further damage to the optic nerve and prevent blindness or development of blind spots in your side vision. There are several forms of treatment, the most common of which is putting drops in the eyes to lower eye pressure. In certain situations, laser treatment or an operation may be needed. 

4) Most glaucoma is completely asymptomatic. Most patients have no discomfort and do not notice the very slow loss of vision in their peripheral field  (side vision) until there vision gets very blurred. In a survey done in high income countries more than half the people found with glaucoma in the community were unaware that they had glaucoma. In low and middle income countries, 90% of all people found to have glaucoma, do not know they have the disease. This is because glaucoma does not have symptoms until it is too late.

5) There are 2 types of glaucoma.  Open angle glaucoma (common and almost always painless) and closed angle glaucoma (less common and often painful). The “angle” is the term we use for “drain of the eye” through which fluid produced in the eye passes out of the eye. Both types of glaucoma can come “out of the blue” (called primary glaucoma) or can be caused by another problem in the eye or the body (secondary)

6) Primary open angle glaucoma is the commonest type of glaucoma found in Africa, Europe and the Americas.  In this type of glaucoma eye pressure can be either high or normal. Because Normal Pressure Glaucoma is extremely common, it is not enough to just have your eye pressure checked, because people with absolutely normal eye pressure can lose vision from glaucoma.

If you would like to understand more about glaucoma, check out the following link

What is Glaucoma

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