Jamie Chang, Yong Loo Lin School of Medicine, National University of Singapore
With Singapore experiencing the onset of the silver tsunami, it is unsurprising that there has been a surging trend in the prevalence of eye diseases such as glaucoma, cataract, diabetic retinopathy and age-related macular degeneration. The World Health Organisation (WHO) Global Data notes that from 2002- 2010, glaucoma and cataract are the leading contributors of blindness, with glaucoma being irreversible and untreatable. With 70 million people affected by glaucoma, Dr Alicia How, Medical Director of Dr Alicia Eye Specialist, discussed on “Complications of Myopia: Glaucoma” during the Singapore Primary Eye Care Symposium (SPECS) 2019 from 23-24 July 2019 at One Farrer Hotel, Singapore.
Glaucoma is a condition that causes optic neuropathy, often linked to the increased intraocular pressure due to an imbalance in the production and drainage of aqueous humour in the eye. It is worrying to note that glaucoma is the cause of 60% of bilateral blindness in Singapore Chinese and an estimated 3% of people under 40 who have glaucoma remain undiagnosed and hence untreated.
The risk of glaucoma increases by 60% in a myopic patient, regardless of age and race. Furthermore, the likelihood of getting myopia-related glaucoma increases with a higher eye refractive power. Dr How also highlighted that refractive surgeries such as hyperopic and myopic LASIK which causes a decreased corneal thickness, increases the risk of glaucoma.
Visual loss from glaucoma is irreversible. However, if detected early, glaucoma can be managed and with appropriate procedures, the patient may not lose their sight completely. Hence, early detection and diagnosis is crucial. Glaucoma can be diagnosed by measuring the intraocular pressure, assessing the optic nerve head and charting any visual field defect.
She also mentioned that an elderly patient suffering from glaucoma may not suffer from blindness in his lifetime and hence practitioners need only observe the glaucoma progression and give treatment when necessary unlike younger patients.
Hence, as myopes are at a higher risk of glaucoma, eye care practitioners should adopt a holistic approach and be on a constant lookout for glaucoma when managing myopic patients.