World Sight Day 2022: Genetic Predisposition To Glaucoma

52-year-old Saurabh Joshi had been suffering from blurry vision for the past 6 months. He ignored it as eye strain due to excess work and had not been for an eye check-up for the longest time. However, over time, as his vision worsened, it became difficult for him to carry out his daily activities including driving.

He finally decided to consult an ophthalmologist and was diagnosed with glaucoma. After performing the necessary tests, the doctor informed him that he had already lost 70% of his peripheral vision, just like his mother. He was unaware that glaucoma could be genetically inherited and that it can run in families.

Joshi is one among the millions of glaucoma patients who suffer from irreversible vision loss due to delay in detection of the condition. An asymptomatic condition, glaucoma causes blindness in 7.7 million people globally. It occurs when the optic nerve gets damaged. This is mainly caused due to an increase in the fluid pressure, (also known as intraocular pressure (IOP) within the eye.

Glaucoma doesn't show any symptoms early on but results in severe vision problems if left untreated. Many are still unaware of glaucoma and the fact that the risk of developing this condition is 10 times more in those with a family history of glaucoma compared to those with positive family history. 

Glaucoma is an emerging peril in India

With over 12 million cases reported in India, glaucoma adds to our country's escalating disease burden. It is the third-largest cause of blindness, after cataract and refractive errors and the topmost cause of irreversible blindness. Glaucoma can be difficult to diagnose as it ‘silently' steals one's vision. There are no symptoms initially, and by the time they appear, the disease has already progressed, increasing the likelihood of irreversible vision loss.

Besides lack of awareness, genetic predisposition to glaucoma is a factor that often gets ignored. Much like diabetes or high blood pressure, glaucoma can run in families too. First-degree relatives (FDRs), particularly, have a higher likelihood of developing the condition. Some warning signs and symptoms include:

• Headache, vomiting, and redness in the eyes

• Experiencing eye pressure and pain

• Areas of scotoma, low, blurry, or hazy vision

• Seeing bright halo rings with colours

Familial glaucoma risk: What one should know

A lot of glaucoma cases are not diagnosed in time due to poor attention to family history. In general, an average individual has a 3.5% risk of developing glaucoma in his/her lifetime. But if your parent or sibling has glaucoma, your risk increases by 10-fold. Other factors such as having pre-existing vision problems, hypertension, diabetes, use of steroids, and tobacco, and alcohol consumption can add to the risk of developing glaucoma.

Catch this vision-killer early 

It is very important that everyone with an identified familial risk goes for preventive eye screening and is monitored regularly. Since it is a disease that mainly develops at a later age, it is recommended that individuals over 40 years of age for a comprehensive eye screening every 1.5-2 years. Those susceptible to vascular diseases or chronic disorders should be particularly alert. 

Early detection is the key to effective treatment as vision impairment due to glaucoma is irreversible. Knowing one's family history, recognising early symptoms, controlling risk factors, and adhering to a disciplined diet and lifestyle can curtail the risk. Lastly, regular and comprehensive eye exams are essential for keeping your eyes healthy!  This can be done once a year in high-risk eyes. 

Content By: Dr. Sirisha Senthil, Head Glaucoma Services, LV Prasad Eye Institute

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