January is Glaucoma Awareness Month, a good time to focus on an eye disease that affects some 3 million Americans and is one of the leading causes of vision loss and blindness. Glaucoma awareness is important because there are typically no symptoms until the disease is advanced and has already caused damage to one or both eyes.
Damage caused by glaucoma cannot be reversed; however, the disease can be treated effectively. While glaucoma cannot be cured, the progression of the disease can be slowed and its negative effects mitigated. This is why glaucoma screenings and early detection are very important.
What is Glaucoma?
Glaucoma is a set of eye diseases that damage the optic nerve. Glaucoma is usually caused by elevated pressure in the eye, brought about by an accumulation of fluids.
The eyes naturally produce fluid on the inside of our eyes. The fluid drains out of a tissue located at the angle where the cornea and iris meet. If the eye produces too much fluid or the drainage system is not functioning properly, excess fluid will accumulate in the eye and increase pressure on the optic nerve. The pressure builds slowly, which is why glaucoma in the early stages is usually not noticeable at all. As the pressure builds, the optic nerve will be damaged.
The most common type of glaucoma is known as open-angle glaucoma. When symptoms do occur, they include patchy blind spots in the peripheral (side) vision or to the central (straight-ahead) vision. These could occur in one or both eyes. Tunnel vision may develop in the advanced stages of the disease.
Another type of pressure-induced glaucoma is acute angle-closure glaucoma, characterized by eye pain, severe headache, blurred vision, nausea and eye redness. Acute angle-closure glaucoma is a medical emergency and requires immediate treatment.
Less commonly, a person may have normal eye pressure, but the optic nerve is damaged anyway – the cause of this type of glaucoma is unclear.
If untreated, all types of glaucoma will eventually cause blindness.
Who’s at Risk?
Anyone can develop glaucoma at any age; in fact, even children can get it, though that is unusual. There are several distinct risk factors for glaucoma
- Age: All people over 60 are at increased risk
- Race: African Americans are 6 – 8 times more likely to get glaucoma. All African Americans over age 40 are at elevated risk. People of Hispanic and Asian descent are also at elevated risk.
- Diabetes: Those with diabetes are twice as likely to develop glaucoma than non-diabetics.
- Other chronic health conditions: Hypertension, migraines and some other chronic health conditions can contribute to glaucoma.
- Other eye problems: Being farsighted, nearsighted or having sustained an eye injury can increase glaucoma risk.
- Genetics: A family history of glaucoma increases the odds of having it.
Diabetes and Glaucoma
Glaucoma is one of several eye diseases that may be caused by diabetes; this group of diseases is referred to as diabetic eye disease. In fact, diabetes is the leading cause of adult-onset blindness. The key to managing diabetic eye disease is similar to managing diabetes itself. That means consistent monitoring of blood sugar and A1C levels, taking all prescribed medications, keeping blood pressure and cholesterol in normal ranges and maintaining a healthy diet and regular exercise routine.
Diagnosis and Treatment
An ophthalmologist can diagnose glaucoma by measuring eye pressure and by inspecting the optic nerve for damage.
While treatment cannot undo damage caused by the disease, it can slow its progression and mitigate the effects of it. The goal of glaucoma treatment is to preserve vision by lowering eye pressure.
Prescription eyedrops are the most common treatment for glaucoma. There are several types of glaucoma eyedrops your ophthalmologist may prescribe. All of them help to reduce pressure by limiting fluid production, improving drainage or both. If eyedrops alone do not reduce eye pressure, your physician may prescribe an oral medication.
Finally, surgery may be an option to treat glaucoma in some cases. Laser surgery to reduce clogging in the eye’s drainage system may be an option for some patients. In other cases, a drainage tube can be surgically inserted to improve fluid drainage.
Early Detection is the Key
Because early detection is so important to preventing permanent vision loss as a result of glaucoma, the American Academy of Ophthalmology recommends that adults age 40 and over have a glaucoma screening and eye exam every four years. For people who are diabetic or have other glaucoma risk factors, screenings should begin before age 40. Visit with your health care provider for specific guidance.
“Regular glaucoma screenings for all adults over age 40 is an important part of our overall good health,” says Dr. Lynne Tilkin, a primary care physician. “With early detection, we can treat the disease and preserve the patient’s eyesight. But if glaucoma goes undetected and untreated, it will eventually lead to blindness.”
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