I WATCHED AT THE distance, the fierce argument between my neighbours, a 60year old lady and her husband. “This pain is too much,” she shouted and threatened to pack out and go back to her parents’! At this, I laughed quietly to myself.  A few days later, I ran into Mr. Jones, her husband in a supermarket. As if he knew what was on my mind he said, “I don’t have one kobo on me. I have just come here to window shop. I am sure you overheard our conversation a few days ago. My wife was complaining that I had not provided any money for housekeeping for three months now. How can I? Since I retired two years ago, my pension has not been paid regularly. I have spent all my life savings on tackling age related health problems both of us never bargained for. Three of our four children have no regular employment since they left the university several years ago. The oldest, a civil servant, has not received any salary for over one year!”

I looked at him and shook my head. Here was a very good man, a hardworking civil engineer, who retired from government as a top civil-servant. If he is facing such challenges, what about countless others. Life is really tough in Nigeria I concluded.

Not too long after, both husband and wife were in my clinic very early in the morning. The wife was in severe pain with the palm of her hand cupped over her left eye.  “We didn’t want to wake you up last night doc,” said Mr. Jones. “We went to visit a friend not too far from us. It was pitch dark when we were returning home. As we were about to open the door of our apartment, my wife suddenly screamed, ‘My eye! My Eye!’ Soon after she started vomiting. I gave her some painkiller. It didn’t help, the pain was too much. She had asked me to call you but I bluntly refused because I thought it wasn’t fair at that time of the night. You know I don’t drive at night because of my poor vision, so I couldn’t take her to a hospital.”

I waited patiently for him to complete his story. Then I asked Mrs Jones a few searching questions. She could barely answer on account of the pain but she did confess to having experienced haloes around lights in the same eye about two days before. I dare not waste further time. She was in agony. She had definitely not slept through the night. I decide to conduct a quick examination of her eyes so I could do something about the pain and ask further questions later.

Vision in her left eye was down to counting fingers at one meter. The eye was beefy red, the supposedly transparent cornea was misty like the windscreen of a car driven in the rain without an air-conditioner. This must have accounted for the severe drop in her vision. The space between the cornea and the iris was almost non-existent; the pupil was dilated and not reacting to light. Next, I measured the intra-ocular pressure. I held my breath as the dial went nearly beyond the limit. It read 62 mmHg in that eye. Normal is 10 to 21mmHg. The pressure in opposite eye was 18mmHg. This was all I needed to confirm my suspicion. 

“Mr. Jones, your wife has angle-closure glaucoma. The fluid pressure inside her left eye rose very quickly stretching the coats of the eye causing severe pain. We have to bring this high pressure down immediately. It may take a few hours but I will give her a strong painkiller to reduce the pain and make her more comfortable.” I did and admitted her for intensive medical attention. I went to see her after about three hours. Mrs Jones was fast asleep, an indication that she was responding to treatment. I woke her up to check her eye pressures again. My face beamed up with a smile. “What is it?” asked Mr. Jones waiting for the good news. “The eye pressure in that eye is now 35mmHg. It isn’t yet normal, but we are gradually moving out of the danger zone. “I can see! I can see better now!” Mrs Jones exclaimed.

“If you promise you’ll continue to use your medications as prescribed, I would let you go home and I’ll see you tomorrow,” I said and added, “Since you live next door to me, please don’t hesitate to call me if the pain should increase or anything unusual turns up.”

Mrs Jones had an attack of angle-closure glaucoma – a very potent cause of sudden painful loss of vision. She had experienced haloes a few days before. Seeing haloes around lights is a warning sign that must never be ignored. Angle-closure glaucoma is not the only cause of seeing haloes around lights. There are many causes but it’s the most dangerous of all because of its potential to cause irreversible blindness within a few days of onset and other long-lasting complications. I could see signs that Mrs Jones’ other eye was in danger of a similar attack. I have arranged for her to have a preventive laser treatment. The left eye has now recovered over 80% of its vision but it can never be completely normal again. There are several challenges still ahead but we shall cross the bridge when we get there.

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