LIVING WITH GLAUCOMA
Even though glaucoma is not life threatening it may bring in changes to your lifestyle and fear for the future. Significant loss of vision may affect driving, employment and independence. With early detection and treatment of glaucoma, glaucoma can be managed and loss of vision may not occur.
- Activities – Playing Wind Instruments, Driving, Wearing Neck Ties, driving, Air Travel.
- Physical Activity – Swimming, Yoga, Weight Lifting, Sexual Activity.
- Medical Conditions -Cataracts in Patients with Glaucoma, dry Eye, Pregnancy.
- Diet – Vitamin B3, Caffeine.
- General – Marijuana/Cannabis, Alternative Therapies.
- Helpful Suggestions – Living with Low Vision
1. Activities
Continuous usage of eyes is not harmful and they need not be “rested”. Reading, writing, computer work and similar activities all encourages to have close focus. Focusing like this will exercise your muscle inside and around your eyes. Making the muscle to work inside the eyes would help the drain in the eyes to work more effectively. Aqueous fluid would drain back to the blood stream more easily and effectively leading to fall of eye pressure. If your eye is getting tired because of prolonged concentration you can rest them periodically. Similarly, long distance viewing like driving, watching television or watching movie in a theater will not harm your eyes.
There are some evidence that says sleeping with physical pressure on an eye can accelerate glaucomatous damage. It is good to avoid sleeping with face downwards and avoid continuous pressure on eyes from the pillows or bedding. There is not specific position that says that is good but it is always better to avoid sleeping positions where physical pressure or strain is put on the eyes. If the individuals glaucoma is well controlled with no sign of deterioration. The goal of the treatment has been accomplished and there is no need of any lifestyle modifications like altering sleeping position.
There are numerous studies that shows higher rate of glaucoma in patients with sleep apnea. People with sleep apnea are advised to get themselves tested for glaucoma.
Musicians who play a high resistance wind instrument (eg trumpet, oboe) experience a high increase in eye pressure and are likely to experience peripheral vision loss. This is related to both the resistance of instrument and the number of hours spent playing the instrument.
If you were clothes with collar (with ties for example) take care not to wear them tight as they would increase pressure on the veins of your head and neck that would increases eye pressure. There is a study that indicate wearing neck ties can contribute to the risk of glaucoma. While the research is not definitive it is suggested that if you could slide a finger between the neck and the collar then the tie shall not alter the pressure in the eyes.
Generally flying has no effect on glaucoma other than a temporary elevation in intraocular pressure (IOP). Following a trabeculectomy there is no increased risk associated with flying this is also applicable to laser procedure. The only risk with flying is that if a procedure has resulted in the retention of air or gas in the eye, mainly pertaining to vitreoretinal surgery. It is necessary to consult your ophthalmologist for any specific concern.
2. Physical Activity
Keeping your weight in control and being physically fit helps prevent health problems i.e. heart attacks and diabetes, and is important for overall wellbeing. By following these same measures can protect you from glaucoma.
This has two forms of effect firstly the measures which are taken to maintain the health of all blood vessels (like avoiding smoking, maintaining normal blood pressure and cholesterol levels, controlling diabetes and body weight) this will increase the blood vessel nourishment of the optic nerve fibers. Secondly, physical activities reduces eye pressure directly for a few hours.
Blood vessel health and visual health is improved by avoiding obesity and by being physically fit. It is highly recommended limit your exercise to your comfort and ability. By exercising there is an added advantage of reducing the eye pressure some hours. The only exercise which has to be avoided are those in which your head is held below the waist so this posture might increase eye pressure.
There are some yoga position that may increase eye pressure in the people with glaucoma. People with glaucoma may have high eye pressure when doing head down position. One of the major cause for damage of the optical nerve in people with glaucoma is due to increase in fluid pressure within the eye.
Usage of swimming goggles also increases eye pressure. It is recommended to avoid goggles with small widths and good to use goggles with a horizontal diameter of greater than 55 mm. if you are swimming with goggles make sure they fit snugly to the bones around your eyes and not apply pressure to the eyeballs.
If you are lifting weights, try to inhale as you lift the weight and don’t hold your breath. This would avoid strain also avoids increasing pressure in the veins of your head and neck which avoids increase pressure in eyes.
Sexual activity from a glaucoma diagnosed perspective in a word yes – just don’t hang your head for a prolonged time.
3. Medical Conditions
Dry eye syndrome usually worsens by topical glaucoma medications (especially preserved medications), it contributes to the overall burden of glaucoma. Dry eye syndrome can be overcome by maintaining eyelid hygiene, warmth and massage, topical lubricants (ideally preservative free) and sometimes changing the topical drop regimen.
Cataract which is found among the glaucoma patients is treatable with the help of surgery. A cataract is the process where your natural focusing lens changes from being transparent to being cloudy.
Glaucoma is commonly asymptomatic it is called the “sneak thief of sight”. By contrast, cataracts usually have symptoms that may impact the quality of life. The symptoms of cataracts may vary with the type and location of the opacity lens you have. Usually patients complain of decreased central vision. This can be observed especially when driving and looking out into the distance.
You may have to stop or adjust your medication when you are pregnant. All glaucoma patients who need treatment with eye drops need to consult their ophthalmologist, possible benefits and potential side effects of any medication may be avoided. When a women who is pregnant is affected by glaucoma there are additional considerations, strategies needed for safe treatment when breast-feeding, or considering having a baby. Now there are two patients involved mother and the baby here it is necessary to consider how the baby’s tissues and organs react to drugs may be quite different from those in adults.
As we all are aware that drugs can have harmful effects on the development of a baby’s organ systems. The earlier the drugs are used in pregnancy, the more frequent and more severe the problems can be. But even later in pregnancy or after giving birth if the infant is being breast-fed, drugs can have unwanted side effects.
When eye drops are instilled there is some amount of drug which is absorbed into the general circulation and which would travels all over the body. It may pass through the placenta and reach in high concentrations in the baby’s blood too. If the baby is being breast-fed, it can also pass into the milk, and thus get into the baby’s circulation as well.
To read more about how glaucoma can affect pregnancy, please go through the article Glaucoma Treatment in Pregnancy
4. Diet
There is no specific diet that is particularly good or bad for glaucoma treatment. Because optic nerves health depends on the health of blood vessels, food that helps in maintain blood vessel health is likely to promote visual health by reducing saturated fats and it is good to have vegetables and fruit. Red wine if taken in small amount tends to reduce eye pressure temporarily. It can be taken with caution as increased quantity will damage the liver.
For most of the individual’s caffeine does not affect the pressure in the eye. However there is increasing evidence that show blood flow can be a factor in glaucoma and this can be influenced by caffeine intake.
It has been shown in experiments that vitamin B3 reduces eye pressure. While human trials are yet to be conducted, there are some hope that by adding Vitamin B3 to existing treatments may be beneficial.
5. General
Alternative therapies like homeopathic and holistic treatment have not been tested for effectiveness against glaucoma. It is advised to be with a valid treatments that has been proven to be effective and safe.
6. Helpful Suggestions
Never hesitate to ask questions
Always instil your eye drops as advised
Be transparent and honest with your doctor (yes, I did missed my drops, for about a week, doctor!!)
Avoid heavily rubbing of your eyes. Such a man oeuvre may raise eye pressures and may contribute to further optic nerve damage.
Living with low vision
Low vision can be defined as visual impairment that cannot be corrected with the help of treatment or tools including glasses, contact lenses or surgery.
With poorer vision comes increasing fear of blindness, social withdrawal and other limitations may occur. Depression, associated along with chronic disease and disability, is usually common in patients with advanced glaucoma, and is associated with reduced quality of life.
If you are experiencing depression or anxiety due to your experience with vision loss, please talk to your doctor or health care professional.