Glaucoma is a group of eye diseases that damage the optic nerve, reducing the quality of vision and even causing blindness. The optic nerve relays signals from the environment to the brain for interpretation and perception. There are two types of glaucoma. Primary open-angle glaucoma occurs gradually, and the patient may not realize the changes in their vision until the condition has caused significant damage to their optic nerve. Angle-closure glaucoma, on the other hand, is more severe and occurs suddenly. It is painful compared to the primary open-angle glaucoma and vision becomes suddenly blurry and can quickly progress to blindness.

Glaucoma is the third leading cause of blindness in the Indian subcontinent. The Asian population is more prone to angle-closure glaucoma than other communities around the world. By 2017, about 11.2 million people in India aged 40 years and above were suffering from glaucoma. 6.48 million of them are affected by open-angle glaucoma while 2.54 are affected by angle-closure glaucoma.

The risk of developing glaucoma increases with age. Previously, studies showed that individuals aged 60 years and above were at a higher risk of developing the condition. However, studies among the Indian population have shown that the age at which individuals start developing glaucoma is as low as 40 years. Unfortunately, many cases of glaucoma in India, especially the primary open-angle glaucoma, remain undetected for a long time. Patients live with the condition for years without seeking treatment, which leads to many cases of irreversible blindness.

Rural populations in the Indian subcontinent are at a higher risk of developing blindness from glaucoma. There is lack of awareness about the condition in rural parts of the subcontinent. At the same time, there is the lack of access to ophthalmologists who would detect the disease early and administer the appropriate treatment.

The primary challenge in catching glaucoma early is that many patients remain asymptomatic even as the condition progresses. If such patients do not seek any regular eye checkups, the situation remains undetected until it is too late. The lack of adherence to treatment among patients whose glaucoma condition is detected early is another major challenge for the Indian population.

There are significant predisposing factors of glaucoma that have been determined in the Indian subcontinent. Besides age, another factor is a genetic predisposition. A family account of the situation puts one at risk as they grow older. Some medical conditions such as diabetes as well as high and low blood pressure can also lead to glaucoma. An individual may develop the condition after suffering from eye trauma due to injury to the optic nerve. Eye conditions such as myopia, corneal thickness, and retinal detachment also lead to glaucoma.

The Indian subcontinent possesses some of the greatest research and breakthroughs in the management and treatment of eye conditions including glaucoma. In urban areas, there are many ophthalmologists who are specialists in eye treatment. Glaucoma patients are always likely to be treated successfully especially when their condition is detected early. The population in semi-urban areas in India can also access the services of ophthalmologists more readily than those living in rural areas.

Treatment for glaucoma in the Indian subcontinent is advanced and is available in three forms depending on the severity of the condition. Some patients are given anti-glaucoma medication to reverse the condition; others are treated using laser surgery, while others undergo filtration surgery. Access to diagnostic equipment, specialists and treatment remain the top challenge for the majority of the Indian population in rural and semi-urban areas.

Fundamentally, there is a need for awareness among the population about glaucoma, the risk factors involved and the need to seek regular eye check-ups. Awareness would encourage the people to seek prompt treatment to prevent the many cases of glaucoma blindness in the subcontinent. There also needs to be more aggressive initiatives to reach out to the population in rural India. They need to have access to specialists and proper equipment to detect glaucoma and receive treatment to reverse the condition and prevent blindness.

Glaucoma remains a major challenge in the Indian subcontinent as in other parts of the world. The key to combating the condition is to actively promote good eye health among the population from an early age. Such an approach will make people more proactive about checking their eyes regularly, and by the time they reach the age of 40; they will have learned how to look out for any signs of glaucoma with the help of their ophthalmologists.

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