January is National Glaucoma Awareness Month

National Glaucoma Awareness Month is sponsored by the American Academy of Ophthalmology and the National Eye Institute (National Institutes of Health).

What is Glaucoma?

Glaucoma is damage to the optic nerve of the eye from pressure in the eye that is too high for that particular patient. The normal range of eye pressure is between 10-21 mmHg. Each patient’s optic nerve is different and some people’s nerves are more sensitive to pressure and some are more resistant. A person can even have glaucoma with “normal” eye pressure. Another person can have high eye pressure and not have glaucoma. It all depends on your optic nerve.

I can see well. I don’t have Glaucoma.

Glaucoma affects your peripheral vision first. You may not notice a change in your vision until it at an advanced stage. Screening guidelines were developed to catch the disease early and prevent vision loss. Once you lose vision from glaucoma, we cannot get it back. Glaucoma is the leading cause of irreversible blindness in the USA.

How do you test for glaucoma?

The screening tests for glaucoma are 1) checking the eye pressure, 2) looking at the optic nerve, and 3) talking about your risk factors for glaucoma. These are part of complete dilated eye exam.

If there is anything suspicious in your screening tests, further testing is initiated including:

1. visual field testing,
2. optic nerve fiber layer analysis,
3. pachymetry,
4. gonioscopy, and
5. photos of your optic nerves.

If anything returns borderline or positive for glaucoma, we can discuss further monitoring and if needed, initiate treatment options depending on each individual patient.

What are the risk factors for glaucoma?

1. Genetics: family history of glaucoma (brothers/sisters, mother/father, cousins),
2. Age: higher risk over age 55 yrs old (over 40 yrs old for African Americans), even higher risk after the age of 70,
3. Race: African American and Hispanics at higher risk for open angle glaucoma; Asians and Native Americans are at higher risk for closed angle glaucoma,
4. Medications: chronic steroid use (nasal sprays, inhalers, pills) for more than 5 years,
5. Other: including trauma directly to your eye, advanced diabetes

What are the different types of glaucoma?

There are many different types of glaucoma. The most common types are:

1. Open angle glaucoma – the most common type in the USA. Usually painless and silent.
   
2. Narrow angle or Closed angle glaucoma – this type can have a glaucoma attack with nausea/vomiting, red eyes, headache, halos, eye pain, brow pain and partial or even complete vision loss and needs immediate treatment. These patients should avoid the medications that say “Do not take if you have glaucoma”.
   
3. Normal tension or normal pressure glaucoma
4. Secondary glaucoma (from trauma, medications, other diseases like pseudoexfoliation, advanced diabetes, pigment dispersion glaucoma)
5. Congenital glaucoma – rare, hereditary and develops in infants and young adults

What are the treatment options?

If you have findings on your exam and testing that indicate you have glaucoma, you and your doctor can talk about the treatment options. The treatment will depend on the type and severity of your glaucoma, and your eye pressure and the level of damage to your optic nerve. The goal is to preserve your vision with close and ongoing monitoring to make sure you are not losing vision and your treatment is working. The treatment options include eye drops, laser eye surgery for glaucoma, and eye surgery for glaucoma if needed.

Where can I learn more?

Talk to your eye doctor about your eyes.

http://www.geteyesmart.org/eyesmart/diseases/glaucoma.cfm

http://midatlantic.preventblindness.org/glaucoma

http://www.nei.nih.gov/glaucoma/