World Glaucoma Week Raises Awareness, May Save Your Sight

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Did you know that up to half of people who have glaucoma experience no symptoms until they begin to lose their sight? This is just one fact important to know as part of the awareness raising mission of World Glaucoma Week.

Vision loss from glaucoma cannot be restored

Glaucoma is a group of eye diseases that affects the optic nerve, the bundle of nerve fibers that connects the retina to the brain and carries messages from the eye to the brain. When the normal fluid pressure inside the eye increases to an abnormal level, it can damage the optic nerve and result in partial or total vision loss.

In many people, damage to the optic nerve occurs gradually over time, resulting in blind spots in a person’s peripheral vision that can easily go unnoticed until they grow so large they cause vision loss. If the damage is caught early in the process, however, treatment can stop or reduce loss of vision.

More than 4 million people in the United States have glaucoma. The most common form is open-angle glaucoma, which occurs when the fluid in the eye drains too slowly out of the eye at the open angle where the iris and cornea meet.

Much less common is angle-closure glaucoma, which occurs when the fluid cannot leave the eye, resulting in a rapid increase in eye pressure, severe pain, nausea, and blurry vision. This condition warrants immediate medical attention.

Some people develop glaucoma even though their eye pressure is normal. Individuals who have normal-tension glaucoma may have an underlying cause, which should be treated. If no risk factors for normal-tension glaucoma can be found, the condition can be treated as open-angle glaucoma, which typically involves eye drops or oral medications.

Glaucoma can also develop as a complication of other medical conditions, such as eye surgery, eye inflammation (uveitis), eye injuries, or certain eye tumors. A severe form of glaucoma, called neovascular glaucoma, is associated with diabetes. In children born with congenital glaucoma, there is a defect in the angle of the eye that hinders normal drainage of fluid. Congenital glaucoma is relatively rare, affecting less than 0.05 percent of all ophthalmic patients.

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Overall, risk factors for glaucoma include older age, being Hispanic or African-American, a family history of glaucoma, presence of elevated eye pressure, being farsighted or nearsighted, a history of eye injuries, and the presence of other health problems, such as diabetes, migraines, or low blood pressure.

Although most risk factors for glaucoma are beyond your control, you should have an eye examination that includes a test for glaucoma every three to five years. If you have a family history or other risk factors for glaucoma, you may want to see an ophthalmologist more frequently.

Among the current research concerning glaucoma is a study being conducted at the Eugene and Marilyn Glick Eye Institute, where investigators are trying to determine if glaucoma is associated with impaired blood flow in the eye. The study, called the Indianapolis Glaucoma Progression Study, is in the second of its three years and is evaluating 120 patients with glaucoma.

According to Alon Harris, PhD, an international expert on ocular blood flow, director of clinical research for the Glick Eye Institute, and the principal investigator of the study, understanding whether blood flow has a role in the eye disease is important because it “could give us different treatment options for glaucoma.”

Currently, treatment for glaucoma includes medications that can reduce the amount of fluid produced by the eye (e.g., beta-blockers, adrenergic agonists, carbonic anhydrase inhibitors, and hyperosmotics) and those that increase the amount of fluid that drains out of the eye (e.g., cholinergics, adrenergic agonists, and prostaglandin analogs). Some medications combine drugs from two different classes. People with glaucoma typically need to take medications for the rest of their lives.

Laser treatment, called laser trabeculoplasty, helps drain fluid out of the eye by expanding the drainage holes. Another option is conventional surgery, which is usually reserved for people who have not responded to medications or laser. Conventional surgery can involve creating a new outlet for fluid in the eye, preventing closure of the drainage angle, or decreasing the amount of fluid produced by the eye.

World Glaucoma Week, which was from March 7 through 13, may be over, but the threat of this serious eye disease remains. By increasing your knowledge and awareness of glaucoma, you may help prevent vision loss for yourself or a loved one.

SOURCES:
Indiana University
National Eye Institute

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