Wednesday, 16 November 2011

Glaucoma in children: Consanguineous marriage blamed for high glaucoma rate in Andhra Pradesh

Syed Akbar
Hyderabad: Glaucoma or blue blindness has emerged as the
leading cause of preventable blindness in Andhra Pradesh with more and
more people preferring marriage within close relations. The incidence
of glaucoma in the State is five times higher than the world average
and doctors blame it on lack of pre-marital genetic counseling and
unchecked consanguineous marriages.

Scores of children, who had successfully overcome the problem of
glaucoma through timely surgical intervention, and their parents
gathered here on Monday over the 17th annual meeting of Association
for Parents of Childhood Glaucoma, coinciding with the Children’s Day.

According to community studies, one in every 3300 live births in
Andhra Pradesh runs the risk of glaucoma as against the world
incidence of one in every 15,000 live births. Glaucoma refers to a
group of eye diseases that have common features including elevated eye
pressure, damage to the optic nerve, and vision loss.

“The incidence in Andhra Pradesh is almost five times higher. There
are various medical and genetic reasons for this, the main being lack
of genetic counseling before marriage and high rate of consanguineous
marriages, particularly children marrying their maternal uncles. Among
adults, the incidence is as high as 10 per cent. Glaucoma can strike
at any age, but timely detection can prevent total loss of vision,”
said Dr Anil K Mandal, glaucoma care specialist at LV Prasad Eye
Institute here.

Childhood glaucoma is associated with physical changes in the eye,
caused by high pressure. The increased fluid pressure can push on the
optic nerve and cause cupping (an abnormal enlargement in the optic
disc area). If the pressure remains too high for too long, the optic
nerve fibres are damaged. Enlargement of the eye, cloudiness of the
cornea and injury to the optic nerve are examples of changes that can
occur as a result of glaucoma, Dr Mandal said.

“It is anticipated that in future years the discovery of additional
genetic markers for glaucoma will be identified. In recent years, a
gene has been identified for juvenile onset glaucoma and has been
mapped to a chromosome named 1q21-31. Another gene called TIGR gene
has been connected to the same chromosome that is linked to steroid
induced glaucoma,” he added.

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