January is Glaucoma Awareness Month, so we want to focus on this disease process and the best ways to diagnose, prevent, and treat it. Glaucoma is a multi-factorial, complex eye disease with its primary characteristics being damage to the Optic Nerve and subsequent visual field loss. Vision loss occurs when the intraocular pressure is too high for the specific individual and therefore damages the optic nerve. This damage cannot be reversed. With glaucoma, side vision is affected first. It may be either gradual or rapid and vision loss may go unnoticed by the individual. Over time, if glaucoma is not treated, central vision (reading, recognizing faces, etc.) can be decreased and lost.
Those at risk for developing glaucoma include those with a family history of the disease, African Americans over the age of 40, and everyone over 60 years of age, especially Mexican Americans. In addition, those who have a poor diet, are lacking in exercise, are overweight and smokers are also at risk. According to the National Eye Institute, more than four million people in the United States have glaucoma. Unfortunately, nearly half of those with glaucoma are not even aware that they have it.¹
Since glaucoma has no symptoms (except in rare cases), and if nearly half of four million people in the U.S. are not aware that they have glaucoma, it would seem to highlight the importance of regular eye exams. Most comprehensive eye exams will include measurement of intraocular pressure, analysis of your visual field, and assessment of the optic nerve. If you have findings that indicate a suspicion of glaucoma or have one or more risk factors for glaucoma, further testing may be warranted. Such special tests may include Optical Coherence Tomography (OCT), Pachymetry, and assessment of the proper drainage of fluid out of your eyes.
Optical Coherence Tomography is like an “MRI” for the eyes and will allow your doctor to assess the Optic Nerve down to the cellular level. An OCT will show the health of you Ganglion Cell layer as well as the Retinal Nerve Fiber layer and allow for monitoring of changes to this tissue over time. Pachymetry measures the thickness of your cornea and the measurement of fluid drainage can be affected by growing cataracts and cause an increase in intraocular pressure. If your doctor deems your cataract to be causing this increase, laser treatment to decrease the pressure or even cataract surgery may be warranted. At this point in time, all glaucoma treatment is focused on decreasing the pressure in your eyes. This can be done with drops, laser, or conventional surgery.
(1) 1. National Institutes of Health, National Eye Institutes, News Brief: Look to the Future: Get an Exam to Save Your Vision From Glaucoma.