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HEALTH UPDATE

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
World Health Organization

January is glaucoma awareness month

Glaucoma

Edited Rhadjena P. Hilliard, MD, MPH


Guyana Journal, January 2009



Glaucoma is the second leading cause of blindness in the world, and the leading cause of blindness in African-Americans. Over 4 million Americans have glaucoma, but only half of them know that they have it because there are usually no early symptoms associated with this condition.

What is glaucoma?
Glaucoma is an eye condition that develops when too much fluid pressure builds up inside the eye. It causes gradual loss of eyesight without warning. Loss of vision is caused by damage to the optic nerve which is responsible for carrying images from the eye to the brain. If left untreated, glaucoma can cause blindness.

There are two main types of glaucoma. The most common type is called open-angle glaucoma. This type of glaucoma develops over time and is dangerous because it develops slowly with no real symptoms. However, with proper screening, it can be treated. Worldwide, more than 3 million people are blind in both eyes from open-angle glaucoma, and more than 2 million people a year will develop it.

Another common type of glaucoma is acute angle closure glaucoma. This type of glaucoma usually develops suddenly and is associated with severe eye pain. This type of glaucoma is more common in Asians.

What are the symptoms of glaucoma?
The most common type of glaucoma, called open-angle glaucoma, causes virtually no symptoms. Loss of vision occurs gradually, beginning with the loss of peripheral (or side) vision. There is usually no pain associated with the vision loss, and a person may not even notice anything until significant vision is lost. Thus, up to half of the people affected by glaucoma may not know that that they have it.

Sometimes pressure in the eye can rise to severe levels, and this can cause sudden eye pain, headache, blurred vision, or the appearance of halos around lights. If any of these symptoms occur, one should seek immediate medical care.

Who is at risk for developing glaucoma?

Anyone can develop glaucoma, even children. However, some people are more at risk than others for developing it. People at high risk for glaucoma should get a complete eye exam, including dilation, every one to two years.

Glaucoma is more common in older people, particularly people over the age of 60, who are 6 times more likely to develop this condition than younger people. Glaucoma is also 6-8 times more likely to occur in African-Americans than in Caucasians, and occurs more frequently, at an earlier age, and with greater loss of vision in this group. Glaucoma is the leading cause of blindness in African-Americans, and screening for glaucoma should begin as early as age 40. Hispanics over the age of 60 may also have an increased risk of developing glaucoma. Other ethnic groups at increased risk of developing glaucoma include people of Irish, Russian, Japanese, Inuit, or Scandinavian descent.

Glaucoma that develops in babies and young children (called congenital glaucoma) is usually diagnosed within the first year of life. However, this condition is rare and typically only seen if there is a family history of relatives with congenital glaucoma. Children with this condition may have enlarged eyes, a lot of tears, cloudiness of the cornea, and sensitivity to light.

Other risk factors for developing glaucoma include the following:
  • Having a family history of glaucoma
  • Having a history of serious eye injury
  • Taking steroid medications
  • Having diabetes
  • Being nearsighted
  • Having high blood pressure

Can glaucoma be prevented?
Although glaucoma cannot really be prevented, screening and early treatment can slow down the progression of the disease.

Regular eye examinations are important, especially for people at an increased risk of developing glaucoma. If a person does not have any symptoms of glaucoma and is aged 40 years and younger, screening every 3-5 years is recommended. However, people over the age of 40, those of African descent, or those with multiple risk factors for glaucoma (like family history or diabetes) should have more regular screening examinations.

How is glaucoma treated?
Many different types of medications, usually in the form of eye drops or pills, can be used to treat glaucoma. These treatments are used to either help the extra eye fluid leave the eye, or decrease the amount of fluid being produced within the eye. Both types of medication will lower the fluid pressure in the eye, which is helpful in treating glaucoma.

There are also two main types of surgery that can be performed to treat glaucoma. One type is called filtering surgery (also called micro surgery). In this type of surgery, small surgical tools are used to create a drainage canal in the eye. Laser surgery is another type of surgery that may be used. In this type of surgery, a small but powerful beam of light is used to make a small opening in the eye tissue.

If you have glaucoma or think you may have glaucoma, your doctor can help you decide which treatment may work best for you.

For additional information on glaucoma, contact the Glaucoma Research Foundation toll-free at
800-826-6693 or email question@glaucoma.org.

Dr. Hilliard is a Senior Content Development Specialist in Horsham, PA.

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