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How to Predict Glaucoma and Prevent It

How to predict glaucoma and prevent it

Glaucoma is a serious eye disease that sneaks up on people because there are no symptoms until damage to vision already has been done. What has been lacking has been a way to predict glaucoma, but new research may have changed that and may even help individuals take steps to avoid it.

Is it possible to predict glaucoma?

At the University of Sydney, Paul Mitchell, MD, PhD, and his colleagues evaluated data from the Australian Blue Mountains Eye Study to see if they could find a way to predict who will develop glaucoma. Data, including diagnostic photos, from nearly 2,500 people were studied.

The Blue Mountains Eye Study (BMES) was the first large population-based evaluation of vision problems and common eye diseases performed in a sample older community in Australia. It was initiated in 1992 and included several follow-up examinations after 5, 10, and 15 years during which photographs were taken of the retina and optic nerve and various health issues were assessed, including diabetes and hearing.

None of the study participants had glaucoma when they started BMES. However, the investigators found that participants who had abnormally narrow retinal arteries at the start of the study were most likely to develop open-angle glaucoma at the 10-year point.

Specifically, the risk of developing open-angle glaucoma was about four times greater among people with narrow retinal arteries than among those with wider arteries at the start of the study. About 3 million people in the United States and approximately 60 million around the world have open-angle glaucoma, which also is the most common form of the disease.

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More about glaucoma
One of the first signs of open-angle glaucoma is an increase in eye pressure (intraocular pressure), but because this is not painful, people don’t know they have this issue unless they have an eye examination that includes a check for glaucoma. Vision loss begins with a decline in side vision, but many people compensate for this by turning their head to the side and don’t realize they have a problem until they have lost a significant amount of sight.

Risk factors for glaucoma include age (it’s more prevalent among older people but can appear in infants as well), smoking, diabetes, high blood pressure, being African American or Hispanic, significant farsightedness or nearsightedness, past eye injury, low blood pressure, migraines, and family history of glaucoma.

How to prevent glaucoma
The American Academy of Ophthalmology recommends everyone get a complete eye examination beginning at age 40 and then following the examination schedule set up by their doctor. People with greater risk factors for glaucoma should be checked more often than those who do not have these factors.

Steps you can take to help prevent glaucoma include the following:

  • Do not smoke or quit if you do
  • Monitor blood pressure and take steps to keep it at a healthy level
  • If you have diabetes, monitor and maintain a healthy blood glucose level
  • Treat elevated eye pressure with medication to reduce the risk of progression to glaucoma
  • Wear protective eyewear when engaging in high-speed racket sports or using power tools or chemicals. Also wear sunglasses year round.
  • At least one study suggests caffeine may contribute to glaucoma

Results of the latest study, which appears online in Ophthalmology, “suggest that a computer-based imaging tool designed to detect narrowing of the retinal artery caliber, or diameter, could effectively identify those who are most at risk for open-angle glaucoma,” according to Mitchell. If additional research confirms these findings, ophthalmologists could have a way to predict who will develop glaucoma and thus have a chance to help prevent the disease.

American Academy of Ophthalmology
Kawasaki R et al. Retinal vessel caliber is associated with the 10-year incidence of glaucoma: the Blue Mountains Eye Study. Ophthalmology 2013 Jan; 120(1): 84-90

Image: Morguefile