Clinics told to keep eye out for glaucoma

PUBLISHED : Sunday, 18 March, 2012, 12:00am
UPDATED : Sunday, 18 March, 2012, 12:00am


Eye doctors from top mainland hospitals are calling on their counterparts at grass-roots clinics to be better prepared to treat glaucoma, as early identification and regular check-ups, which generally happen at lower-level hospitals, are essential for treatment.

This week marks World Glaucoma Week, jointly set up by the World Glaucoma Association (WGA) and the World Glaucoma Patient Association (WGPA). The campaign was extended from one day to one week last year to boost awareness of the eye condition.

According to the WGA, glaucoma is the second most common cause of blindness worldwide, after cataracts.

But unlike cataracts, which can be cured with operations, glaucoma is irreversible. It is estimated that 4.5 million people globally are blind because of glaucoma, and the number is expected to rise to 11.2 million by 2020.

About half of affected people in developed countries are unaware they have the condition, and that figure may rise to about 90 per cent in underdeveloped parts of the world, the organisation said.

Dr Fu Mingshui from the Shanghai First People's Hospital echoed those figures, estimating that about 90 per cent of mainlanders with glaucoma have not been diagnosed for two reasons: they do not go to hospitals for examinations, and if they do go, many doctors are not able to tell if the patient has glaucoma because of a poor understanding of the disease. 'There is a high percentage of misdiagnoses, especially with early and middle-stage glaucoma,' Fu said.

Dr Lin Yunxia from Shenyang's He Eye Care Hospital, the biggest optical centre in northeastern China, said that many doctors at grass-roots hospitals were lacking in their knowledge about glaucoma and were not familiar with the screening methods, which are simple.

'For example, for elderly people who are presbyopic [increasingly unable to focus on near objects] and suffer from eye and head pains, doctors should consider the possibility of glaucoma. But to my knowledge, about 50 per cent of doctors at community clinics refer these patients to neurology departments. That will just prolong their treatment,' Lin said. 'Therefore, it's necessary to ramp up the education among doctors at low-level clinics.'

There are about 20 million people on the mainland who have glaucoma, roughly a quarter of all those affected globally, Fu said. While the condition can attack people of all ages, the occurrence tends to be highest among older people. He says the disease affects 2 per cent of people above 40, and 7 per cent of people above 60.

Fu said the majority of Chinese do not know what glaucoma is, and they regard it as a type of cataract. 'Many people think glaucoma can be removed and that their eyes can recover after surgery, like with cataracts.

'When I told them that glaucoma can't be healed, even with surgery, and that it is a life-long illness, some patients can't accept this fact and most feel distressed,' he said.

Lin says people typically misunderstand the disease, thinking it means a person will have eye pains. However, before the late stage of its development, glaucoma does not cause pains, but rather narrows the sufferer's field of vision. That is why glaucoma is described as the 'silent blinding disease'.

Dr Meng Fanrong from the Eye & ENT Hospital of Fudan University said that regular check-ups on eye pressure and visual field are also important for patients who have already had an operation to treat glaucoma, as the recurrence rate is 15 to 20 per cent.




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