By Dr.Doug Safley,
January is Glaucoma Awareness Month in the United States. Glaucoma is a leading cause of blindness in the United States and the number one cause of blindness in African Americans. Early treatment may substantially reduce the likelihood of severe vision loss but many people who are at high risk for this disease do not have regular eye exams. A comprehensive examination is necessary to determine if glaucoma is present and may require additional testing with a device called a visual field analyzer. This instrument determines the retinal sensitivity and is used to both detect and follow visual loss that is caused by glaucoma. Unfortunately, this loss is usually not detectable by the patient and therefore many individuals at risk fail to get examined regularly because they still see "just fine." Glaucoma does not usually reduce a person's sharpness of vision until much later in the course of the disease.
Glaucoma has two major subtypes -- chronic open angle glaucoma, the most common type, and narrow angle glaucoma. In either case, the result is an increasing pressure within the eye. New research indicates that an enzyme -- brain derived neurotrophic factor or BDNF -- plays an important role in preventing vision loss from glaucoma. At the present time, however, there is no way of providing this if you do not naturally have it. Rarely, one may experience an acute attack of glaucoma which causes severe pain and steamy vision.
It is estimated that three million Americans have glaucoma yet only half are aware of it. Unlike other problems that may cause pain and force one to seek treatment, normal glaucoma does not cause pain nor does it cause any noticeable problems for the patient and so they put off their annual eye exams. That is why many people with glaucoma go undetected. As many as 120,000 Americans are blind from this disease and it costs the taxpayers over $1.5 billion annually.
Although glaucoma can occur at any age, African Americans over 40 and anyone over 60 are more at risk. Age related changes that occur in the eyes can make glaucoma more of a risk over time. The peripheral vision is usually affected first and if left untreated for too long can cause tunnel vision. It is then that one may start to notice a problem and seek care if they have not had annual eye exams. The problem is still treatable in most cases but the damage is not reversible which is why it is so important to detect it early and treat it appropriately.
Glaucoma may be treated using a variety of methods including medication or surgery. In this country, the primary method is to use eye drops to lower the pressure inside the eye. When this no longer is effective, laser surgery may be used to improve outflow of fluid from the inside of the eye thereby lowering the pressure. Other surgical techniques may also be used to accomplish the same thing and some are used to reduce the fluid coming into the eye as well.
Glaucoma is a serious sight threatening disease that generally has no symptoms. The only way it can be detected is through very thorough eye examinations. Many of the people that have glaucoma have pressure considered to be normal so one cannot rely on pressure measurements alone. Glaucoma is treatable in Montana by both optometrists and ophthalmologists. The key is regular eye exams with your doctor. Protect your eyesight. Get your annual exams.
