The Sneak Thief of Sight

A sly and silent enemy.  A painless and persistent enemy, slow of pace but startling cruel once entrenched.  Indeed, in far too many cases, nearly half a victim’s vision is already gone before its presence is even recognized.  It is thought by experts that as many as one million of us have the disease right now, today, and don’t know it.  There is no cure.  Unlike the drama of macular degeneration or the warning clouds of cataracts, glaucoma does its work of stealing away sight by damaging the eye’s optic nerve with essentially no symptoms.  And once vision is gone, it’s gone.  The loss is permanent.

January is Glaucoma Awareness Month.  What does this mean to us, actually?  Is this a useful or important thing in our lives?  Yes, truth be told.  Glaucoma is a leading cause of blindness.  Well over 60 million people worldwide have this disease, along with about 2.2 million Americans.  And America’s population is aging.  The Glaucoma Research Foundation anticipates an epidemic of blindness in the offing unless awareness is raised about the importance of preserving vision.  Early detection and treatment is the best way, perhaps even the only way,  to fend off vision loss.  Once again, we embrace prevention, prevention, prevention as always, always, always better than attempts to cure.

The National Eye Institute (NEI) recommends that all Americans at risk of glaucoma undergo a comprehensive dilated eye exam every one to two years.  Risk factors for the disease include age, being near-sighted, having diabetes, having a family history of glaucoma and/or taking steroid medications.  People of African, Asian and Hispanic descent over age 40 are at higher risk, as are all people over age 60.

An eye specialist will use the following five tests in order to make an accurate diagnosis of glaucoma.  Each of the tests checks different factors, all important aspects of detection:

  • Ophthalmoscopy.  This test, also known as a dilated eye exam, checks the shape and color of the optic nerve.
  • Tonometry.  This involves an examination of inner eye pressure.
  • Perimetry.  This is a visual field test that checks the total field of vision.
  • Pachymetry.  This is a test of the thickness of the cornea.
  • Gonioscopy.  This test examines the angle in the eye where the cornea and iris meet.

Glaucoma is part of a group of diseases that attacks and damages the optic nerve.  The optic nerve is a bundle of nerve cells that serves to relay visual information to the brain from the eye.  In primary open angle glaucoma, the most common form of the disease, pressure from inside the eye causes nerve damage.  This intraocular pressure happens when the fluid that circulates in and out of the front portion of the eye drains away too slowly.  If this goes undetected and proper treatment is not secured, the disease eventually affects central vision and the march towards blindness is on.  Irreversible blindness.

Glaucoma is a challenging and complex disease and, while strides are being made towards developing ways to reverse its damage, progress towards a cure is slow.  Medications and procedures can certainly help prevent further vision loss once the disease is detected.  Eye drops and pills may help control the eye pressure, and there are surgical options as well.   A laser-based surgery, called trabeculoplasty, improves the flow of fluids out of the eye and can be done in a doctor’s office.  A more traditional surgical approach, called trabeculectomy, allows a doctor to create a new drainage path under the eyelid.

Tomorrow, we will take a look at some of the most promising research under way about glaucoma, as well as the new detection and prevention techniques being studied.  We will also share some good educational links.  A survey by the NEI established that while more than 90 percent of Americans have heard of glaucoma, barely 8 percent know it has no early warning symptoms.  By age 65, one in three of us will have some form of vision-impairing eye disease and glaucoma is in the top four.  We need to get the word out – clearly!

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