Healthy Living Newsletter
Don’t have tunnel vision about Glaucoma
 Most American are aware of the dangers of hypertension (high blood pressure). In fact, we’re reminded of the importance of keeping blood pressure under control through the routine blood pressure check that starts off almost every visit to the doctor. But how many of us are aware of the dangers of ocular hypertension - a build up of fluid pressure in the eyes that often leads to glaucoma?
Awareness of glaucoma, or lack thereof, can be largely attributed to the fact that it is largely a silent disease until late in the disease process when damage has already been done.
The disorder is also invisible, even to those already diagnosed. Patients don’t experience symptoms: they can see well enough, and there’s no pain. As a result, there’s often a tendency to minimize the importance of daily treatment.
Glaucoma develops when the fluid (aqueous humor) produced by the eye fails to drain properly. This fluid normally circulates in the chamber of the eye between the cornea and the lens.
In a healthy eye, fluid is produced, circulates and drains to maintain an even pressure in the eye. When fluid fails to drain properly, excess fluid builds up, creating an increase in pressure. Too much pressure in the eye damages both the optic nerve that carries signals from the eye to the brain and the visual field.
Glaucoma affects over 2.2 million Americans, most of them seniors.
Although there is no cure, it can be treated and controlled, preventing further damage to the eyes. Left untreated, it can progress and interfere with peripheral vision, leaving patients with only the central visual field intact, a condition often called tunnel vision. Uncontrolled glaucoma can also lead to blindness. In fact, glaucoma is the second most common cause of blindness in both eyes in the world. Diabetes ranks first.
In an ideal world glaucoma would always be diagnosed in an early stage, before serious damage has occurred. Once diagnosed, it can be treated with either medication or surgery.
Diagnosis is painless and relatively easy. The fastest and least invasive test is air-puff tonometry. In this test a puff of compressed air is directed at the cornea. The momentary flattening of the cornea is measured, giving a reading of pressure within the eye. Another test known as contact tonometry, that very briefly touches the eye, is also often used.
Glaucoma testing is performed by ophthalmologists as well as optometrists. Regular testing is recommended for adults, especially for those over age 60 who should have a complete eye exam from a physician every two years.
When glaucoma is diagnosed, two of every three patients will be able to manage the condition with medicated eye drops. One in three patients will eventually require at least one surgical treatment. Follow-up surgical treatments are often necessary. Medication to treat glaucoma works by reducing the amount of aqueous humor produced by the eye or by increasing the drainage. Many of the available drugs do both.
Patient compliance is one of the biggest challenges physicians face in treating patients with glaucoma. Patients often forget to use their drops, fail to refill prescriptions or just don’t seem to realize how crucial it is to use the drops to control pressure every day. Physicians play a key role in educating patients and encouraging them to stay motivated with treatment.
Glaucoma has the potential to damage eyesight and even cause blindness. Yet the ability to protect our eyes with regular screening and treatment gives us the power to protect one of our most precious senses. A little preventive care can keep your eyes safe from this all too common but preventable cause of blindness. |
