Farmers may have an increased risk of developing glaucoma, due to pesticide exposure, a glaucoma specialist warned.
Glaucoma is a neurodegenerative eye disease classed as one of the leading causes of blindness.
Consultant ophthalmic surgeon at the Beacon Hospital, Graeme Rogers, spoke to Agriland to raise awareness of the chronic eye disease that is reportedly on the rise in Ireland, ahead of World Glaucoma Day, which falls today (Wednesday, March 12).
Glaucoma is the overarching name for a series of related eye diseases that result in progressive and irreversible damage to the eye’s optic nerve, culminating in a deterioration of vision or a complete loss of sight.
While some studies indicate that farmers may be more pre-disposed to glaucoma, as a result of their exposure to toxic pesticides which can accelerate stem cell degeneration, their active lifestyle could make them well placed to counter the disease, Rogers explained.
“From what I recall, there was a paper a couple of years ago demonstrating that, in a group with severe glaucoma, farmers were found to have an increased risk, and the suspicion being that it was a result of occupational exposure to pesticides,” Rogers said.
“Now there are no big prospective stock studies, so it’s difficult to know what degree or level of exposure is required to cause severe glaucoma.
“But it does seem to make sense because some pesticides have been proven to cause neurodegeneration, or stem cell death, which is effectively what glaucoma is,” Rogers said.
According to the World Glaucoma Association, one in 200 people over the age of 40 have the disorder, the majority of whom remain undiagnosed.
The disorder is particularly prevalent among older patients, with one in eight over the age of 80 affected.
Glaucoma prognosis
While there is no current cure for glaucoma, early intervention is key in controlling it, Rogers said, who has urged all those over 50 to attend regular screenings with their optometrist every two years, irrespective of whether they have observed any vision defects.
This is because “more than half ” of glaucoma cases are asymptomatic, Rogers said.
“You cannot eliminate glaucoma once the diagnosis is made. Once there’s nerve damage, that cannot be undone.
“Fortunately, it is well managed these days, so that only a small proportion of glaucoma patients actually end up going blind, maybe less than 10% of all patients.
“If a person is determined to have changes suggestive of glaucoma and the diagnosis is made, probably more than 90% of those impacted will be well-controlled, provided they see their glaucoma specialist regularly,” he explained.
Some patients may not even notice their vision deteriorating over time, until a greater proportion of their optic nerves has been damaged, while many more are at risk of falsely attributing waning vision to old age, as opposed to a neurodegenerative condition.
“Some people are still being referred to my clinic quite late for numerous reasons, putting it down to other factors like getting older, when in actual fact, they have a progressive degenerative disorder.
“Those individuals can still be controlled to a point where they can maintain their vision, but they may have permanently lost some element of their vision, due to the late referral,” Rogers added.
He also advised everyone to familiarise themselves with family medical history, due to the genetic component of the disease.
Individuals with impacted first-degree relatives are 10 times more likely to develop glaucoma, the World Glaucoma Association approximated.
“There are probably 50 to 80 kinds of glaucoma subgroups and many of them are genetically passed down. If you have a first-degree relative with glaucoma, one must be more prudent with or meticulous with screenings,” Rogers said.
“If, for example, a person is very short-sighted or very long-sighted, or has a history of eye trauma, eye surgery, diabetes, or vascular disease, such people should also be checked more routinely for glaucoma.”
Rogers recommended regular exercise and a healthy diet, as a means of mitigating the risk of developing glaucoma or reducing its severity once a diagnosis has been made.
“We’re all scared of losing our vision but because we now have so many options at our disposal in terms of management and treatment of these degenerative conditions, the prognosis of glaucoma is much better now than what it used to be 50 years ago,” he added.
