January is National Glaucoma Awareness Month and it’s a great opportunity to take a closer look at the condition and what you can do to protect your eyesight from the risk of glaucoma damage.
Glaucoma is actually a disease of the optic nerve in the back of the eye and represents the second cranial nerve so glaucoma is truly a neurological eye disease. Here is the most frightening statistic: 50 percent of all people in the United States that have glaucoma don’t even know it!
We know that elevated pressure inside the eye is a key factor that can lead to glaucoma (everyone has an eye pressure, much like blood pressure). But over half of all patients with glaucoma never develop elevated eye pressure so we know that other factors such as poor blood flow to the eye and brain may be responsible. Genetics can also play an important role, so anyone with a family history of glaucoma is at risk for developing glaucoma. We also know that certain ethnicities are at greater risk of developing glaucoma such as African-Americans and the Hispanic/Latino population. In addition, researchers have found a strong association of glaucoma with sleep apnea disorders. Certain medications such as steroid eye drops, nasal inhalers or steroid creams used around the face can instigate glaucoma as well.
Interestingly, high blood pressure is not an outright risk factor for glaucoma, although we see low blood pressure, especially in women as being an additional risk factor due to the reduced blood flow to the brain and eye. Along those same lines, recent studies also point to activities such as yoga where some of the poses that require inversion for extended time periods can lead to reduced ocular blood flow. For men, that tight necktie can also restrict blood flow and result in increased eye pressure. However, recent research has reinforced our belief that regular exercise (at least those not requiring you to stand on your head!) is protective against developing glaucoma.
When detected early, glaucoma is a very treatable disease. The most common and effective treatment is a once or twice a day eye drop that lowers the pressure inside the eye. Roughly 50 percent of patients require one eye drop and the other half require two or more different types of eye drop medicine per day. Approximately 20 percent of patients will require a painless in office laser procedure to lower the pressure. Unfortunately a small percentage of patients develop progressive vision damage despite medical treatment and require surgery to lower their pressure to a safe level. In addition, some people at very high risk of developing glaucoma who have elevated eye pressure are sometimes treated prophylactically to keep them from converting to glaucoma.
So what is your best defense? Keep in mind that glaucoma is completely asymptomatic in over 90 percent of patients until the vision has become significantly damaged. Your best bet is an annual comprehensive eye examination that includes measurement of your eye pressure and a dilated examination of your optic nerves. This is important: even if you have good vision and don’t need glasses you still need an eye exam EVERY year. Think about it, most people see a dentist once or twice a year, yet your teeth are essentially replaceable. Your eyes are not and the average eye exam frequency is a poor once every 3 years! Imagine life without vision. It’s hard to believe that anyone would put their vision in jeopardy because they failed to get their eye examination. It is no wonder that more than 50 percent of all glaucoma patients are unaware that they have a potentially blinding eye disease. Add this to your list of New Year’s resolutions: Get an eye exam!
Dr. Ben Gaddie is the owner of Gaddie Eye Centers and President of the Kentucky Optometric Association. He is also the Vice President of the Optometric Glaucoma Society and Chairman of Continuing Education for the American Optometric Association. He can be reached at 502.423.8500. www.gaddieeye.com and www.kyeyes.org.