Glaucoma, a neuro-degenerative disease that affects 2.5 million people nationwide, accounts for 12% of blindness in the US and is the second leading cause of blindness worldwide. This condition occurs due to damage of the optic nerve that leaves the back of the eye and carries visual information to the brain. The damage occurs when the pressure in the eye (called intraocular pressure) is too high for the cells of the optic nerve to cope with and these nerve cells slowly begin to die. When these cells die, the eye is unable to produce new cells to replace them and vision loss results.
Glaucoma is widely known as “The Silence Thief of Sight” because, unlike high blood pressure, high eye pressures gives no clues or symptoms to its presence and vision loss from this condition occurs in patients’ peripheral or side vision and in early stages is nearly impossible to perceive. By the time vision loss is noted, the disease is nearing end stages where treatment is least effective. Even more disturbing is that half of the individuals in the US that have glaucoma, don’t know it. The prognosis is often very good if glaucoma is identified and treated at an early stage with only about 6% of patients reaching legally blind criteria; without treatment, however, that number rises to over 30%! For this reason, complete ocular health exams are strongly encouraged for everyone and especially those with a higher risk of developing glaucoma.
Risk Factors play a big role in the development of glaucoma. If you have any of these risk factors, it is highly recommended to receive routine eye care.
• High Eye Pressure (Intraocular Pressure)
• Age: As your eyes age, the likelihood that you may develop glaucoma increases. Those who are over 60 years of age tend to develop glaucoma at a rate of 6 times higher than those under 60.
• Ethnicity: African Americans and Latino Americans develop glaucoma at a rate that is 6-8 times higher than Caucasians. In fact, glaucoma is the leading cause of blindness for Americans with African ancestry.
• Family History: There is a very strong genetic correlation between positive family history and a patient’s risk factor for developing glaucoma. If you have a mother, father, brother, or sister who has been diagnosed with glaucoma, your chances for developing the disease over your lifetime increases to almost 20%.
• Use of Certain Medications: Steroids, whether taken orally, inhaled (i.e. in treating asthma), or topically (i.e. eye drops), have been shown to increase eye pressure in certain people. When the eye pressure is increased, glaucoma can result. If you are using steroids for treatment of a medical condition, it is important to let your eye doctor know.
• High Nearsightedness (Myopia): Those who are highly nearsighted have a tendency to develop glaucoma at a higher rate than those who have “average” spectacle prescriptions. Those who are nearsighted may be twice as likely to develop glaucoma, according to a 2011 study.
• Sleep Apnea: Those who have chronic obstructive sleep apnea have a 1.67 times greater risk for developing glaucoma when compared to those who do not have sleep apnea.
Diagnosis and Treatment of Glaucoma
There is no cure for glaucoma. The goal of management is to identify glaucoma at the earliest stage possible and prescribe treatment to slow down the disease process to a point where remaining vision is preserved. Diagnosis of glaucoma is reached through non-invasive in-office testing to measure the amount of nerve tissue damage as well as the degree of side vision changes present. If Glaucoma is confirmed, treatment is aimed at lowering eye pressure (intraocular pressure). For the majority of patients, treatment involves the daily use of eye drops. There are also some surgical options available if treatment with eye drops is ineffective or inappropriate. Regardless of the treatment used for glaucoma, it is important to realize that there is no cure for this disease. The treatments are aimed at slowing down the disease process and preventing further vision loss.