Can You Spot the Signs of Glaucoma?
The National Eye Institute (NEI) estimates that more than 3 million people in the United States have glaucoma, and they project that number will increase to 4.2 million by 2030. Glaucoma is the leading cause of irreversible blindness, and although it often presents with little to no symptoms, it is highly preventable. That’s why the American Academy of Ophthalmology™ turns its focus every January to helping raise awareness about glaucoma.
Often called the “sneak thief of sight,” glaucoma is actually a group of diseases that can damage the eye’s optic nerves. It rarely presents with any symptoms in the early stages, and usually by the time symptoms do present, irreversible eye damage and vision loss have occurred. Experts assert that of the 60 million people worldwide who have glaucoma, half don’t know they have it.
“There are two major types of glaucoma, and each type acts on your eyes in a
different way,” says Karen B. Saland, M.D., an ophthalmologist and physician on the medical staff at Texas Health Dallas. “The more common type of glaucoma is called open angle glaucoma, and the second, less common type is narrow angle glaucoma. Both of these types of glaucoma damage the optic nerve by increasing the amount of pressure placed upon it.”
Inside the eye, there are two chambers: anterior and posterior. The anterior chamber is constantly creating a fluid that nourishes the cornea and maintains intraocular pressure. However, in patients who have glaucoma, this fluid does not drain properly, leading to a buildup of fluid and pressure on the optic nerve.
There is also a third type of glaucoma known as low tension glaucoma, which is similar to open angle, but optic pressure readings are within normal ranges while still causing damage. Any disease that causes or contributes to increased eye pressure can also result in optic nerve damage and vision loss, referred to as secondary glaucoma.
The prevalence of glaucoma increases as we age, but those who are most at risk are African Americans 40 years of age or older and Mexican Americans who are 60 years old or older. That being said, glaucoma can still affect anyone over the age of 60, regardless of race or ethnicity, especially if you have diabetes or a family history of glaucoma.
Understanding your family history of glaucoma can help you and your doctor get a head start on screening, but Saland says that unfamiliarity with your family history shouldn’t keep you from getting help.
“Family history can be tricky to learn for some patients due to various reasons. It is important however that you don’t assume that just because you don’t know the health history of your family or no one has or has had glaucoma, you will or will not have glaucoma,” she advises. “Family history is one factor that puts you at greater risk for having the disease but it does not mean you will necessarily have it. Therefore, when you have your next appointment with your eye doctor, just express to them that you are concerned about glaucoma affecting you and tell them what you know of your family medical history.”
Although glaucoma is generally symptomless in the beginning stages, Saland says small vision changes will start in the peripheral or side vision first, creating vision similar to tunnel vision. Since many of us do not regularly use our peripheral vision and therefore don’t notice slight changes in our it, Saland adds that it is important to receive regular, comprehensive screenings.
“It is very important that you have your eyes checked as directed by your eye doctor. This allows the earliest possible diagnosis,” she says. “This can help with proactive treatment and management of your eyes based on early warning signs, before it has progressed to the point of affecting the optic nerve; in doing so, you can greatly reduce the chances of any permanent vision damage from glaucoma.
“A basic glaucoma screening that only checks the pressure in the eyes is generally not adequate in diagnosing glaucoma,” says Saland. “Diagnosis occurs through a complete dilated eye exam with your ophthalmologist.”
Treatment for open angle glaucoma usually involves medication in the form of eye drops. In some severe cases, laser treatment or surgery may also be required. Treatment for narrow angle glaucoma is a simple, in some cases in-office, laser procedure.
“In the procedure, a small opening is made in the iris with a specialized laser to allow proper draining and in turn reduce the pressure on the optic nerve.”
If you need some help jump starting the conversation with your doctor or ophthalmologist, Saland recommends asking questions like:
- There is (or is not) a family history of glaucoma. Does this put me at risk for getting or having glaucoma?
- Is the pressure in my eyes within the normal limits?
- Is the appearance of the optic disc suspicious for glaucoma or any other disease?
- Is there a reason to be concerned about the possibility of glaucoma?
- Does the overall health of my eyes concern you in any way?
- Am I a glaucoma suspect or do I have glaucoma?
Even though glaucoma is not 100 percent preventable, Saland adds that it does not have to be inevitable.
“Life is busy, and it can be cumbersome to go to the ophthalmologist, get your eyes dilated, and then not be able to work or study for a short period. This small sacrifice could pay off in the long run, though, if we can detect eye diseases before they become severe and cause any permanent damage.”
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