“The Sneak Thief of Sight” Is On Our Minds This January

January is Glaucoma Awareness Month

Make your resolution for healthy vision this year by knowing the risks and signs of glaucoma.

As the leading cause of blindness worldwide, glaucoma has earned the nickname “The Sneak Thief of Sight”. This is because often there are either no symptoms or a sudden onset of serious symptoms that can quickly lead to vision loss if not treated.

Glaucoma-related vision loss is usually caused by optic nerve damage due to elevated pressure within the eye (intraocular pressure). The damage cannot be reversed however there is treatment for glaucoma, particularly when it is caught early before nerve damage has occurred.

While anyone can develop glaucoma (children are sometimes even born with it) there are risk factors that increase the chances of developing the disease. These include:

• Age over 60 (over 40 for African Americans)
• Family history of the disease
• High eye or blood pressure
• African American, Japanese, or Hispanic descent
• Previous eye injury or surgery
• Diabetes
• History of corticosteroid treatment
• Severe myopia (nearsightedness) or hyperopia (farsightedness)

Known measures to help prevent glaucoma or reduce the risks include maintaining a healthy diet and weight, regular exercise, refraining from smoking and protecting your eyes from UV exposure. Controlling blood pressure is also beneficial.

Types of Glaucoma

There are two main types of glaucoma, open-angle and angle-closure, with open-angle being the most common and accounting for approximately 70-90% of cases. Open-angle refers to chronic cases of the disease that progress slowly over time, and are usually caused by high intraocular pressure. Angle-closure glaucoma can be chronic or acute and is often caused by an inherited condition or the result of an injury to the eye.

While each of these types of glaucoma has subtypes the major differences between them have to do with the way the disease affects the eye and the symptoms. While open-angle often has no early symptoms yet may eventually cause loss of peripheral vision, angle-closure glaucoma is often characterized by more obvious signs such as blurred vision, pain, headaches, tunnel vision, halos that appear around lights and even nausea and dizziness. These symptoms can be a medical emergency and must be treated immediately.

Detecting Glaucoma

Since there are often no symptoms as glaucoma develops, regular glaucoma screenings are key to early diagnosis and treatment. Such screenings should include an exam of the optic nerve, measuring the inner eye pressure and visual field screenings. Some cases of glaucoma occur with normal or even low eye pressure (low tension glaucoma) and therefore people should not rely on any vision screenings where all they do is an “airpuff” test.

Newer technologies such as OCT, can painlessly scan the optic nerve and determine if there is glaucomatous damage even earlier than visual field tests or other exams might show.

Treatment for Glaucoma

While vision that is lost from glaucoma’s damage to the optic nerve can’t be restored, the eye can be repaired (and intraocular pressure returned to normal) to prevent further damage and loss. Treatments include eye drops and surgery, depending on the type of glaucoma, the cause and the severity of the disease.

If you have been diagnosed with glaucoma and prescribed eye drops, it is important to keep using the eye drops as directed even if the drops irritate your eyes or you do not notice improvement in vision. The eye drops prevent eye pressure spikes that can damage the optic nerve. Since the vision loss from glaucoma is not reversible, if you have concerns with the eye drops, ask your eye doctor to try out a different brand instead.

Childhood eye injuries, such as a ball hit or puncture, particularly one which altered the internal structures of the eye or allowed fluid to flow out of the eye can cause problems later in life. Glaucoma that results from such long-forgotten injuries may not be detected until years after the injury, so it is important to have routine eye checkups if you have ever sustained an eye injury.

The best way to protect your eyes and vision from this devastating disease, especially if you have heightened risk factors, is to ensure you have regular comprehensive eye exams to look for signs of glaucoma inside the eye. Since symptoms often don’t appear until damage is done, the best course of action is preventative.

If you have any of the risk factors listed above, when you come in for your yearly comprehensive eye exam, speak to your eye doctor about glaucoma and what you can do to prevent it.