Eye Conditions and Diseases
What is a cataract?
Cataracts are a common eye condition, primarily affecting older adults. Here are the key facts:
- Blurred Vision: Cataracts cause blurry vision, often described as seeing through a gray fog.
- Distance Vision Affected: The blurriness is most noticeable at distances greater than 3 meters (about 10 feet), making it hard to see details. Glasses don’t improve this type of blur.
- Progressive Condition: As a cataract develops, the fog thickens, and vision worsens. In severe cases, only light perception may remain.
- Serious Consequences: Untreated cataracts can lead to significant vision problems.
- Treatable Condition: A simple surgical procedure can restore sight in most cases.
- Common Surgery: In Norway, approximately 50,000 cataract surgeries are performed each year.
Cataracts in Africa
Cataracts pose a significant challenge in Africa, impacting both children and adults. They are very common, often developing at a younger age and progressing more rapidly than in other regions. Several factors contribute to this increased prevalence, including genetic factors, sun damage, poor nutrition, injuries, inflammation, and other eye diseases. The result is a more rapid progression to visual impairment and blindness. Fortunately, cataract surgery offers a solution.
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This simple and painless procedure typically takes about 10 minutes, using only eye drops for anesthesia. During the operation, the patient’s own lens is replaced with an artificial lens that gives the patient clear vision again. The artificial lens usually consists of a plastic material. The lenses can be folded and implanted in the eye through an incision of 2-4mm. The artificial lens has a lifetime durability, but cannot be compared completely with the body’s own lens. The most common form of cataract surgery is called Small Incision Cataract Surgery. The operative form is often abbreviated as SICS.
What is a glaucoma?
Glaucoma encompasses a group of eye diseases that damage the optic nerve, ultimately leading to vision loss. A key characteristic of these diseases is the damage inflicted upon the optic nerve, which subsequently results in the disappearance of portions of the visual field. Elevated pressure within the eye is a recognized risk factor, and treatment strategies, therefore, focus on reducing this pressure through various methods like eye drops, laser treatment, or surgery. Glaucoma can manifest as either a chronic or acute condition, and both forms are considered serious due to their potential to cause reduced vision and, in the worst-case scenario, blindness if left untreated. A particularly challenging aspect of glaucoma is its often subtle onset, as visual acuity is typically the last function to be affected, making early detection difficult.
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The prevalence of glaucoma varies considerably across the globe. In Norway, for instance, approximately 2% of the population over the age of 40 is affected by glaucoma. However, the situation in Africa is significantly more concerning, with glaucoma occurring 10 times more frequently than in Norway and affecting younger individuals to a greater extent. Furthermore, access to essential medications like eye drops is often limited in Africa, which unfortunately contributes to a higher incidence of irreversible blindness due to glaucoma. Despite these challenges, organizations like Right to Sight have been working to improve access to treatment. For over a decade, we have provided selective laser trabeculoplasty (SLT) treatment to African patients affected by glaucoma, and the results of these efforts have been very positive.
What are refractive errors?
Problems with how your eyes focus, like nearsightedness (myopia), farsightedness (hypermetropia), or astigmatism (where the cornea, the clear front part of your eye, is shaped unevenly), are called refractive errors. These problems are usually easily fixed with glasses or contact lenses, helping you see clearly.
Around the world, the most common reason people have trouble seeing is because of uncorrected refractive errors. This means that many people who are blind or partially sighted could see much better if they just had access to an eye exam and glasses.
The World Health Organization (WHO) estimates that of the 253 million people worldwide who are blind or have serious vision problems, 123.8 million are affected by uncorrected refractive errors, and 65.2 million by cataracts. These are the two main causes of vision loss.
In fact, up to 75% of all blindness and poor vision is avoidable, either through glasses, contacts, or surgery. A staggering 89% of people with blindness or low vision live in developing countries, highlighting the need for better eye care services in these areas. Children are especially at risk.
If vision problems in young children aren’t corrected, their eyes may not develop properly, leading to permanent vision damage that can’t be fixed. This can make it much harder for a child to learn and participate fully in life. Many of these vision problems are simple to correct with the right care and equipment. That’s why it’s so important to reach out to people in rural and underserved areas, which is a key part of Right to Sight’s mission.
Other conditions
What is AMD?
Age-related macular degeneration (AMD) is an eye condition that mainly affects older adults. There are two main forms:
- Dry AMD: This is the more common and less severe type. It doesn’t involve any fluid leaking in the retina (the light-sensitive tissue at the back of the eye). Currently, there’s no treatment for dry AMD.
- Wet AMD: This type is more serious. It occurs when blood vessels in the retina start to leak fluid. Treatment for wet AMD involves injecting medications called VEGF inhibitors into the eye. These medications help to stop the leakage. These injections usually need to be repeated many times, sometimes monthly, for years.
Both dry and wet AMD can make it harder to see clearly, making activities like reading difficult. However, peripheral vision (used for walking) is usually less affected, so people with AMD can often still get around safely.
What is trachoma?
Trachoma is a contagious eye infection caused by a bacterium called Chlamydia trachomatis. It’s a major cause of blindness worldwide, particularly in developing countries with poor sanitation and limited access to healthcare. Children are especially vulnerable to trachoma, and repeated infections over time can cause serious damage.
Here’s how trachoma progresses:
Initial Infection: Trachoma often starts with mild symptoms, resembling conjunctivitis (pink eye), such as redness, itching, and discharge. In children, these initial infections can be frequent and easily spread.
Repeated Infections & Scarring: With repeated infections, the inside of the eyelids becomes inflamed and scarred. These scars can cause the eyelids to turn inward (entropion), so the eyelashes rub against the eye.
Trichiasis & Corneal Damage: This painful condition, called trichiasis, where eyelashes scratch the cornea (the clear front surface of the eye), eventually leads to further scarring and clouding of the cornea. The cornea, which should be perfectly transparent to allow light to enter the eye, becomes opaque, progressively blurring vision.
Blindness: If left untreated, trachoma can lead to irreversible blindness due to the severe damage to the cornea. The constant pain from trichiasis can also be debilitating.
Trachoma spreads easily through close contact, particularly among family members, and can be transmitted by flies that carry the bacteria. Prevention strategies focus on improving hygiene, access to clean water, and sanitation. Treatment typically involves antibiotics, and in advanced cases, surgery may be needed to correct the eyelid position and prevent further damage to the cornea. Early detection and treatment are crucial to prevent the devastating consequences of trachoma.
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