“AN EVENT OF great significance is happening all over the world in the second week of March 2018,” said the Generalissimo. “What is this?” I asked. “It’s BIG! March 12 to 18 is the World Glaucoma Week and the whole world will be united in a fight to Beat the Invisible Glaucoma,” he replied and added, “I want you all to get up, stand up and fight.” Since his great speech several weeks ago, I have been calling him Generalissimo because of his commitment to the fight against blindness from Glaucoma. “But how can we win a war against an unknown enemy? It is invisible and seemingly invincible as well. What are we going to fight with?” I pondered quietly in my mind. When Bola (not real name) at 54 presented in the eye clinic several years ago, complaining of frequent headaches, fatigue and general feeling of being unwell, she was very sure it had something to do with her eyes. She had taken antimalarial medications and had treatment for typhoid but no respite. So she thought she had glaucoma. I examined her from head to toe. I was alarmed by the outcome of my physical examination so I scribbled a note to the lab for a pregnancy test. The result came within the hour - she was pregnant! Several months later she gave birth to a bouncing baby boy.

Bola’s symptoms led to a full physical examination which helped me to identify the signs typical of a normal pregnancy state. By urine and blood testing, it was possible to obtain additional objective evidence that Bola was pregnant. Unfortunately there are neither symptoms nor signs during early stages of glaucoma. The sufferer is completely at ease and unaware of any problem in his eyes. Damage (loss of vision) must occur before symptoms or signs are noticeable by the sufferer and quantifiable by the doctor. Thus the glaucoma patient is at a considerable disadvantage. He has no hint that he is in danger of becoming blind until he is face to face with the danger of blindness. Even more upsetting is that an initial visit to the specialist may coincide with the early stages of the disease when the patient has no symptoms and the doctor sees no signs of the disease. If stupidly, the patient does not repeat his visit in subsequent years, he may be stunned several years later when he is told he has advanced glaucoma. The only way you can protect yourself is by repeating the visit every year. 

How then can we fight and hope to win the war? From a simple blood test, a diagnosis of pregnancy was made in Bola. Are there simple tests to detect the presence of glaucoma before there is any functional or structural damage? Yes, technology is coming to the rescue. Various gadgets are already out. The latest central visual (CVF) machines would tell us about early loss of function while Optical Coherence Tomography (OCT) would tell us about the structure of the optic nerve.  Apart from the fact that these are expensive tools are not within the reach of those who actually need them, they do not have the finality of a pregnancy test. The search continues!

On Thursday, March 15, the Generalissimo is inviting you to join the war against Glaucoma. Remember you can’t fight a battle without weapons. Your most important weapon is a white T-shirt. Buy a white T-shirt and simply ask them to print on its back Beat Invisible Glaucoma.  Make sure you wear it to work and everywhere you go on that day! We hope the traffic officers and other uniformed law enforcement officers will also don the garb. If you like, you may join our campaign train on the streets. Your presence in your white T-shirt would be the cynosure of all eyes and help the cause of creating awareness. Let’s join hands together to make this year’s World Glaucoma Day Campaign the quietest, yet the nosiest and most successful of all seasons. Get up, stand up and fight Glaucoma! Let’s Beat the seemingly Invincible Glaucoma. 

“The campaign is just one aspect of the war against Glaucoma,” said the Generalissimo, his face beaming with excitement. “What else has he up his sleeves?” I wondered. “I believe very strongly, that the cause and cure for Glaucoma will be found in Africa, specifically in Nigeria,” he concluded. “He must be an incurable optimist,” I thought. “What meaningful contributions have we made to glaucoma research since Oyin Olurin OFR described the pattern of the disease in Nigeria several decades ago? Very little,” I asked and answered simultaneously. “I am embarking on a massive campaign to raise 10billion naira for Glaucoma Research,” he said with great confidence. “Sir, how would you achieve this feat in a country like ours where …..?” He didn’t allow me to complete the sentence. It was like he had read my thoughts. He quickly added, “Dr Ben, just wait until then. We shall raise 10billion naira and more. Do I have your support?” “Yes,” I mumbled feebly mindful of the challenges ahead.