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Treacherous blindness




“O loss of sight, of thee I most complain!”

  John Milton (1608–1674), English poet,

  Samson, in Samson Agonistes (1671)

Dr. Jose Pujalte Jr.

Dr. Jose Pujalte Jr.

John Milton didn’t have it exactly right for he went on with: Blind among enemies, O worse than chains, Dungeon, or beggary, or decrepit age!”That is to say, sometimes going blind comes with “decrepit age.” That is, if we are talking about glaucoma, which together with cataracts and diabetic retinopathy constitute the top causes of blindness in the aging.

Definition. According to, glaucoma is not a single disease entity but a group of conditions resulting in “optic nerve damage which diminishes sight.” The usual cause is an abnormally high pressure within the eye (intraocular pressure). A quick look at patient information webpages have three key messages: 1) glaucoma has no warning signs; 2) if untreated, glaucoma causes vision loss or blindness; 3) those at higher risk of glaucoma should get an a dilated eye exam every one or two years. Who are at risk? The book says everyone older than 60, a family history of glaucoma, co-morbidities such as diabetes, high blood pressure, heart disease and hypothyroidism. Being nearsighted (myopia) increases the risk of developing glaucoma and so does prolonged use of corticosteroids, particularly corticosteroid eyedrops.

 Signs and Symptoms.  Note that there are two common types – the primary open-angle glaucoma and the acute angle-closure glaucoma. Their signs and symptoms are different. In the primary open-angle type, there is gradual loss of peripheral vision (vision at the sides) and may involve both eyes. In the advanced stage, the patient has tunnel vision.  In the acute angle-closure type: severe eye pain, blurred vision, halos around lights, reddening of the eye, sudden onset of visual disturbance, and even nausea and vomiting.

Diagnosis. See your favorite eye specialist, the ophthalmologist. Your doctor will explain why glaucoma occurs and the basic explanation is that pressure within the eye is so elevated that it begins to damage the optic nerve. So tests will confirm that through tonometry, tests for optic nerve damage, and others.

Treatment. Doctors will warn you that glaucoma cannot be cured completely and whatever damage has occurred cannot be reversed. Treatment focuses on reducing the pressure within the eye by improving the outflow of the fluid that accumulates, reducing the amount of this fluid, or both. Your eye specialist will offer medications and surgery.

Glaucoma eyedrops can reduce pressure up to 22%. Preventing glaucoma includes regular eye checkups with the recommendation of once a year after the age of 60. We have to back to the message that glaucoma has no warning signs – that alone should be a reason to see your doctor.



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