Don't let the word glaucoma scare you
Of all the five senses — taste, smell, sight, hearing and touch — most people probably rank sight at or near the top of those that are most precious. Yet they often fail to take the simple precautions necessary to preserve it with preventive measures such as a glaucoma screening. Yes, glaucoma is a leading cause of blindness. Yet, if it's caught early and treated, vision loss can almost always be prevented.
What is glaucoma?
How to preserve your vision
Three modes of treatment
What is glaucoma?
"There are many kinds of glaucoma, but they all have one thing in common: a buildup of pressure in the eye that is too high for the optic nerve," says
Courtland Schmidt, MD, a Virtua ophthalmologist and glaucoma specialist. "As we learn more, we know that there are other things that contribute to glaucoma such as blood flow to the eye and individual susceptibility. The most important factor, however, is the pressure inside the eye."
To understand how glaucoma develops, the
Glaucoma Foundation uses a simple analogy: Think of your eye as a sink in which the faucet is always running. The "water" in the eye is called aqueous humor, a fluid that is constantly flowing through the eye, providing nourishment to the iris and lens. The eye's "drain" is a very thin, spongy tissue called the trabecular meshwork. In some people, this drain becomes clogged, and aqueous humor cannot leave the eye as fast as it is produced. This causes the fluid to back up, putting pressure on the optic nerve — the part of the eye that carries visual information to the brain.
Glaucoma is especially frightening for two reasons: Most people who develop it have no symptoms, and any vision lost due to glaucoma cannot be restored. "People with glaucoma can't feel the pressure in the eye and don't usually notice changes in their vision; so they don't have their eyes checked until they notice a vision problem," says Dr. Schmidt. By this time, it's usually too late. "Individuals can lose 80 to 90% of their sight before they notice a change," warns Dr. Schmidt.
Preserving your vision
According to the Glaucoma Foundation, the risk for developing glaucoma is greater for people who are over age 45. African Americans, people who have first-degree relatives who have had the disease, or those who have abnormally high intraocular pressure, diabetes, or nearsightedness are also susceptible. Other risk factors include long-term use of steroids or cortisone, and a history of eye injuries.
"The best defense against glaucoma is regular testing in the form of a complete eye examination," says Dr. Schmidt. Those who are under age 45 and have no risk factors should have their eyes checked every four years; those over 45 with no risk factors should be tested every two years. For people with risk factors, screenings should be more frequent: every two years for those under 45 and every year for those over 45.
Testing for glaucoma is simple and painless. At the Virtua Eye Diagnostic Treatment Center physicians use state-of-the art technology to measures the eye's pressure, determine the field of vision, and view the optic nerve for changes in color and appearance.
This includes a new device, called the Heidelberg Retina Tomograph (HRT), which is a highly sophisticated tool that detects smaller degrees of change in the optic nerve than traditional examinations provide. The exam is fast, safe and usually doesn't require dilating the eye. The patient sits in a stationary position as a laser scans the eye for just a few seconds. This new instrument also provides essential information for monitoring the disease in follow-up exams.
Three modes of treatment
Glaucoma is treated with eye drops, lasers or traditional surgery, with eye drops generally tried first. Dr. Schmidt is optimistic about a person's outcome if the disease is caught early. "There are so many good treatments for glaucoma," he says. "Those receiving treatment have an excellent chance of keeping their sight. Getting diagnosed early is the best defense, and must occur before someone can be treated appropriately."
As it turns out, glaucoma isn't all that frightening after all. The tests are simple, the treatments are effective, and the prognosis is excellent for people who are diagnosed early. So go ahead and get a screening. It's a small price for saving the precious gift of sight.