Glaucoma: Avoiding the Silent Disease

As we’ve kicked off this New Year feeling refreshed and looking forward to carrying out our many New Year’s resolutions (some being more realistic than others of course...), let’s add one more thing to that list: Seeing the best that you can in 2017.

January is National Glaucoma Awareness Month meaning there’s no better time to start the conversation about this often talked about condition. In this article, I will try to explain what exactly Glaucoma is while clearing up some common misconceptions along the way!

What is glaucoma?

Glaucoma is a disease that is caused by buildup of pressure within the eye. Over time, this elevated pressure causes damage to the optic nerve, and in turn, will cause a gradual but progressive loss of peripheral vision. If left untreated, glaucoma can eventually lead to blindness.

The pressure rises due to fluid buildup in the front compartment of the eye. Our eyes create a fluid called aqueous that circulates within the front portion of our eyes. In order to keep the pressure stable, a healthy eye will create a small amount of fluid that flows into the eye while the same small amount of fluid will flow out the eye. When this fluid balance does not happen effectively, you are left with a buildup of pressure within the eye.

Up until this point we’ve discussed the most common form of glaucoma, primary open-angle glaucoma, however it is possible to have a form of glaucoma where the intraocular pressure can be at normal levels—this is called normal tension glaucoma. Other, less common, types of glaucoma include:

• Normal-tension Glaucoma
• Angle-closure Glaucoma
• Congenital Glaucoma
• Secondary Glaucoma

When discussing glaucoma, the conversation usually revolves around “eye pressure”. While eye pressure (intraocular pressure or IOP) is one of the key factors in monitoring and managing glaucoma, it is only one of several other important factors considered. Two very important components examined includes the actual appearance or health of the optic nerve and measuring for any loss of peripheral vision. The other parts looked at include family history, corneal (the front window of your eye) thickness, and the drainage angle of your eye. It should also be noted that eye pressure will vary throughout the day, so a single reading may not be sufficient in diagnosing glaucoma.

How can glaucoma be detected?

Glaucoma, sometimes called “the silent thief of sight”, is a group of diseases that causes progressive and irreversible vision loss. As the pseudo-name implies, glaucoma will show no symptoms until advanced stages where a lot of optic nerve damage has already occurred.

Signs of glaucoma are much more readily observed by an optometrist during a comprehensive eye exam as opposed to being detected by the patient who will not notice any visual symptoms until the condition has reached severe stages. Unfortunately, any vision loss that has already occurred is irreversible.

The way that we approach glaucoma treatment and management has changed drastically over the years. The ways in which it’s changed is nicely outlined by our article found here. We employ the latest technology in glaucoma management including the Humphrey visual field analyzer, Cirrus Optical Coherence Tomography (OCT), and the most up-to-date retinal photographers. By combining these tools with prior research on glaucoma, we are capable of seeing things from a vantage point that wasn’t possible in the past, giving us and the patient the upper hand.

How is glaucoma treated?

Glaucoma is a slowly progressive disease that does not stop, which means that there is no simple cure to halt its progression entirely. Currently, the mainstay treatment for glaucoma is medicated eye drops that work to lower intraocular pressure. The goal of glaucoma treatment is to preserve and prolong vision for as long as possible while attempting to steady optic nerve damage.

There are quite a few glaucoma drops that can effectively control pressure, and will vary case-by-case depending on each patient’s specific goals as determined by your managing optometrist. Aside from eye drops there are also laser surgeries, and now implants, that can help improve the drainage system of the eye, however the goal is still the same: to control the damage and preserve vision.

Who gets glaucoma?

There are several notable risk factors for glaucoma. The groups of people that are more at risk include those who are:

• Over the age of 60
• Of African American or Hispanic heritage
• Of Asian heritage (at higher risk for Angle-Closure glaucoma)
• Have a family history of glaucoma

Other risk factors may include high nearsightedness, use of steroid medications, diabetes, and having thinner than average corneas.

In conclusion

I’d like to wrap up withby mentioning two of the most common things that I will hear from my patients:

“I haven’t noticed any change in my vision.”

“I don’t feel any pressure inside my eyes.”

Both of these statements are more than likely true, but they also lead us back to one very important point: glaucoma is a silent disease and is not recognizable until its advanced stages when significant optic nerve damage has already been done. Also, remember that even though high eye pressure is closely involved with glaucoma, it is possible to develop glaucoma without it.

Finally, like most health conditions, early detection is your best friend. If you happen to have glaucoma, the sooner you “catch” glaucoma, the sooner you and your optometrist can begin strategizing a treatment plan that’s fit for your unique scenario. With today’s advancements we have available to us here, glaucoma detection and treatment have never been more efficient and promising.