Going Blind Slowly

Several common conditions are responsible for progressive, painless vision loss. Glaucoma, often referred to as the “silent thief of sight,” is a condition that causes damage to the optic nerve due to elevated eye pressure. The loss of peripheral vision begins and extends towards the center; once central vision is affected, that loss is irreversible. Diabetic retinopathy is another significant cause in which high blood sugar levels damage the retina’s blood vessels. Early on, vision may appear normal, but small leaks and tiny bleeds begin to blur the sight. 

Age-related macular degeneration is another culprit affecting the central retina, responsible for sharp vision. It often starts with slight distortion or mild central blurring but without treatment it can cause serious central vision loss. Cataract is a slow clouding of the lens, causing hazy, dull vision and glare. However, it is easily treatable with surgery but many delay treatment until their vision has become severely reduced. Hypertensive retinopathy, due to high blood pressure, also causes damage to retinal blood vessels, often before the patients are aware that they already have hypertension.  

And in Malaysia, these silent changes are reflected in population data. According to the National Eye Survey conducted in 2014, the leading causes of blindness among the population aged 50 years and above were untreated cataract (58.6%), diabetic retinopathy (10.4%) and glaucoma (6.6%). More recently, in a 2024 publication based on the 2023 survey, the prevalence of blindness among older adults in certain Malaysian regions has decreased but remains significant. In the Eastern region, the prevalence of blindness dropped from 1.4 % to 0.8 %, and in Sarawak from 1.6 % to 0.6 %. In a Kuala Lumpur outpatient study, cataract was the most common diagnosis (21.3%), followed by glaucoma (12.3%) and diabetic retinopathy (8.4%).