More than three million Americans have glaucoma, yet only half know that they have this eye disease, which is the second leading cause of blindness. Approximately 120,000 Americans have lost their sight due to glaucoma, which gradually robs your eyesight without warning.
How can so many people have this serious disease without knowing it? “An individual with glaucoma has no symptoms until the disease is very advanced,” explains Polly A. Henderson, M.D., a glaucoma specialist and Instructor of Ophthalmology at Drexel University College of Medicine. “That is why regular eye exams and testing for glaucoma are absolutely essential for all adults. Testing is painless and it could save your eyesight.”
What is Glaucoma?
Glaucoma is a disease of the optic nerve caused by pressures in the eye that are too high. While there are several types of glaucoma, the most common one in our population is primary open-angle glaucoma. In this type, the high pressure occurs when fluid drains too slowly out of the eye, resulting in damage to the optic nerve, which carries visual information from the eye to the brain. As nerve cells die, vision is slowly lost, usually beginning with peripheral, or side, vision. The disease doesn’t affect central vision until it becomes more advanced and at that point, it is more difficult to treat.
Risk Factors
Although anyone can get glaucoma, some individuals are at higher risk. Family heredity plays a primary role in this disease. “If you have family members such as parents, grandparents or siblings who have glaucoma, it is especially important to be tested regularly,” says Dr. Henderson.
African-Americans are also at high risk. Glaucoma is six to eight times more common in African-Americans than Caucasians, and African-Americans age 45-65 are 14 to 17 times more likely to go blind from glaucoma than Caucasians with the disease in the same age range, according to the Glaucoma Research Foundation. Other high-risk groups include people over 60, diabetics and people who are severely nearsighted.
“Although glaucoma occurs more often in older people, recent studies show that up to 25 percent of Americans suffering from glaucoma are under age 50,” notes Dr. Henderson. “It’s important for every young adult to be tested every two years. If someone in your family has glaucoma, you should be tested annually."
Testing and Treatment
“To test for glaucoma, we put drops in the patient’s eyes, which may cause minor discomfort,” Dr. Henderson continues. “The drops dilate the eyes so we can examine the optic nerve. If we see anything suspicious, we conduct visual field screening to see if the patient has any loss of vision.”
“The importance of routine glaucoma testing can’t be overemphasized,” states Dr. Henderson. “It can definitely save people from going blind. Although there is currently no way to prevent or cure glaucoma, we have good treatments to slow the progression of the disease.”
A patient diagnosed with glaucoma has several treatment options. Topical medications in the form of eyedrops reduce pressure in the eye either by slowing the flow of fluid into the eye or by improving fluid drainage. “Regular use of these eyedrops controls the increased fluid pressure in the eye for most people,” notes Dr. Henderson. “The drops are easy to use, usually just once or twice daily. However, some people don’t use them regularly because they don’t yet have any vision loss and, therefore, don’t think they need medication. This is why some patients lose much or all of their vision to glaucoma. You must use the eyedrops every day for them to be effective in preventing progression of the disease.
“Don’t let cost be a factor in getting proper treatment,” emphasizes Dr. Henderson. “Less expensive generic brands of the eyedrops are now available. In addition, some pharmaceutical companies have programs in which they work with doctors to provide these medications at reduced cost to patients who cannot afford them.”
In cases where the disease progresses despite the use of eyedrops, laser treatment is another option. In this painless procedure which can be done right in the ophthalmologist’s office, a laser is applied to the areas where fluid drains from the eye to improve the drainage and reduce pressure. Patients who have this treatment may also need to continue using eyedrops.
Surgery is usually reserved for patients whose pressure cannot be controlled with eyedrops or laser treatment. “With surgical treatment, we create a new site in the eye to filter and drain fluid,” explains Dr. Henderson.
“Generally, glaucoma is a very slow progression disease, and if diagnosed early, the patient has a good chance of keeping the disease under control and retaining vision,” states Dr. Henderson. “A general ophthalmologist can perform baseline tests and refer you to a glaucoma specialist. Remember, even if you don’t have symptoms, you could lose your eyesight if you aren’t tested and treated, just as a person with high blood pressure who goes untreated can suffer a stroke. The earlier you are diagnosed and treated, the better the outcome.”
For additional information or to schedule an appointment, please call Drexel Eye Physicians at 215-762-EYES. |