We’re a few months into the new year, so it’s a little late to be talking about resolutions, but we’ve got one more to add to this list: get checked for glaucoma. Now, not all of you really need to add this – younger readers aren’t really at risk of developing glaucoma in the immediate future; however, if you’re over 60 years old, or have a family history of glaucoma, you’d better whip the 2015 list out one more time.
Glaucoma is a common, often very hard-to-catch eye disorder. So hard to catch, in fact, that a comprehensive examination is often the only way to definitively diagnose it. Although no one likes to visit the opthalmologist any more than they have to, early detection of glaucoma is the closest thing you’ll find to a guarantee of effective treatment. The longer a case goes untreated, the more damage it does and ultimately, the more difficult it is to help someone with it.
If you fall into any of the at-risk demographics (we’ll go over them below), and even if you don’t, consider making time for an appointment sooner rather than later. After all, it may be the one thing that saves your sight.
What is Glaucoma?
Glaucoma is a widely applied term that covers a range of diseases that damage the optic nerve, a part of the eye responsible for relaying visual information to the brain. However, for most intents and purposes, the word refers to one disease: primary open-angle glaucoma. Open-angle glaucoma affects as many as 1% of all Americans, many of whom have absolutely no idea that they’re living with it.
Often referred to as “the silent killer of sight,” open-angle glaucoma progresses without causing any obvious symptoms – or really any symptoms at all. While the exact causes are still being studied, open-angle glaucoma manifests as very slowly increasing intraocular (within the eye) pressure. As this occurs, the cornea adapts, but does not swell, meaning that the disease can progress without any physical signs. Prolonged exposure to this higher pressure will eventually kill nerve cells in the eye, which causes a glaucoma patient to lose parts of their field of (usually peripheral) vision.
Age is often the primary risk factor for development of glaucoma. The older you are, the more likely you are to run into the disease. Risks become particularly pronounced for anyone 60 years of age or older.
Race also figures into the conversation. Some ethnic backgrounds are more predisposed to glaucoma. African Americans have an elevated chance to contract glaucoma, and also tend to do so at younger ages, and should start scheduling exams after age 40. Mexican and Asian Americans should also be extra wary of glaucoma.
As with many other diseases, family history is also important. If you have relatives, particularly close relatives, who have developed the disease, you yourself are likely at greater risk as well.
Other factors may also be important in determining risk. Diabetics often have damaged blood vessels in their eyes, a problem that can lead to impaired blood flow, followed by an increase in intraocular pressure. Hypertension may also stack the odds against you. Various eye disorders can indicate a potentially at-risk eye – nearsightedness (myopia), farsightedness (hyperopia), eye inflammation or injury, and certain types of eye surgery have all been identified as red flags.
The sneaky progression of glaucoma makes it highly unlikely for a sufferer to diagnose themselves. Closed-angle glaucoma, a different variant of the disease, can announce itself with an incredibly painful acute closure. Still, closed-angle accounts for only 10% of glaucoma cases, while open-angle, the much more common version, is completely painless.
Loss of peripheral vision can be a sign of advancing glaucoma, but it happens much too slowly for an average glaucoma patient to notice. No, the only sure way to catch glaucoma is schedule regular exams. The advised frequency of these visits vary depending on risk factors, but as a general rule, individuals older than 40 should begin scheduling occasional visits. Over 65, exams should be conducted every two years, and possibly even more frequently if a person is deemed to be at-risk.
Once inside a opthalmologist’s office, glaucoma becomes a little easier to catch. A physician can test intraocular pressure, field of vision, corneal thickness, and do a fluid-tracking test called a gonioscopy. And after a case is detected, treatment can begin.
While there’s no full cure for glaucoma, early treatment can control the disease, halting its progression and giving extra years of healthy vision to a patient. Prescribed eye drops and pills can both effectively reduce the buildup of pressure within the eye. If taken consistently, this is often enough to keep an advancing case at bay without taking more drastic measures.
If drastic measures are called for, surgery is the go-to solution. Laser surgery either relies on either increasing the drainage capacity of an eye, or damaging its ability to manufacture more fluid. The net result of either method is hopefully a reduction in the volume of liquid in the eye. If laser surgery fails, traditional surgery is the next step. Surgeons seek to create new drainage paths for fluid, or to implant small drainage devices.
In any case, it’s important to note that early treatment is vital. Increasing intraocular pressure isn’t a death knell for healthy sight, but it has to be controlled quickly. If left unchecked, the damage it does to nerves in the eye is completely irreversible. Sometimes, it’s best not to delay that exam; if you find yourself checking off a few of the risk factors listed above, then it’s time to call in and schedule an eye exam.