What Does My Grandmother
Want
You to Know About Glaucoma?
Let me tell you a little story . .
.
You’ve heard the expression, “Don’t
wait until the horses escape to close the barn
doors”.
That expression applies to glaucoma as
well. Glaucoma, the silent thief of sight, steals
away your sight. When it is finally discovered it is
much more difficult to treat than if found sooner.
Sadly, lost vision can never be recovered.
But what does that have to do
with my grandmother and why am I so passionate about
glaucoma?
Because my grandmother went
blind from it.
She has been gone for many years
but I can still remember the difficulty she had in her later
years. My grandfather, her husband, was an optometrist
like I am, but back in those days there were really very
few accurate tests to catch glaucoma in its earliest
stages. Think how frustrating it was for him, who had
dedicated his professional life to helping people with their
vision, not to be able to do anything for his own
wife whom he had been married to for over 60 years.
And the best eye specialists in the city were helpless
also. The horrifying thing about glaucoma is that
the longer you have it and don't treat it, the more difficult
it is to control it.
They dealt with it as well as they
could and would even joke about it. My grandfather was
nearly deaf and she was blind. So they said she was the
ears and he was the eyes! Almost as sad as her
inability to do the things that she used to love to do - cook
(her apple pies were my favorite) and read - was the
loss of her independence. She couldn't even walk by
herself or find the chair to sit down at the dinner
table. She could only recognize her grandchildren by their
voices. They used to comfort themselves by saying that she
would soon have new eyes in heaven. She got her new eyes
in heaven.
Fortunately today we have MANY more
ways of detecting glaucoma and MANY more effective ways of
treating glaucoma. So there really is no excuse anymore
for going blind from glaucoma.
But
almost half of Americans with glaucoma don't know they have
it.
Since glaucoma gradually reduces your
peripheral vision you are not aware of the loss until
permanent damage has already been done. For this reason,
glaucoma often progresses undetected until the optic nerve is
irreversibly damaged. In fact, glaucoma is responsible
for at least some vision loss in the almost 3 million
Americans estimated to have it. It is the leading cause of
blindness among African Americans and Hispanics.
So
what does my grandmother want you to know about
glaucoma? She wants you to know that now there is no
excuse for you to get glaucoma because of all the advanced
testing and treatments available.
Special
Offer
Did
you know that Medicare will cover you for a glaucoma screening
if you have any of these risk factors?
·
African Americans aged 50 or more
·
Hispanics aged 65 or more
·
Diabetics
·
History of glaucoma in your family
Call 913-498-1363 today!
What Increases Your Risk for
Glaucoma?
·
Age – over 40
·
African Americans,
·
Hispanics
·
Diabetics
·
Glaucoma “running in the family”
·
Previous eye injuries
·
Steroid drugs for chronic health conditions
·
Farsightedness
What is
Glaucoma?
Glaucoma is an eye disease that causes
damage to the optic nerve. There are two major
categories of glaucoma. Open angle (chronic) and closed
angle (acute).
Open angle glaucoma is by far the most
common. The “angle” referred to is part of the anatomy
of the front of the eye that drains away fluid. Glaucoma is
usually – but not always- caused by a build-up of pressure in
the eye. Even though the “drain” is not physically small
pressure still builds up and then causes damage to the optic
nerve - the nerve connecting the eye to the brain. If
the nerve is damaged all of the information that the eye is
trying to send to the brain doesn’t get there, and a
loss of vision occurs primarily in the peripheral (side)
vision at first. Later it occurs directly on center and then
you have a devastating loss of vision.
How can you tell
if you have open angle glaucoma?
The simple answer is that you can’t. Only your eye
doctor can tell for sure. If you have open angle glaucoma
you are not likely to notice vision loss until it is too late
– just like my grandmother. In fact, you can still have
20/20 vision and have loss of your peripheral vision from
glaucoma.
The
loss of sharpness of vision (visual acuity) does not become
noticeable until late in the disease. By that time you
will have tunnel vision and will be aware of a significant,
permanent loss of vision.
What is acute
angle-closure glaucoma? This is much less
common than open angle glaucoma. It occurs in
approximately 10-15% of cases. The angle (drain) of the eye is
simply too small for the fluid (aqueous humor) that is
constantly being secreted to drain out of the eye.
Therefore, if the drain becomes suddenly clogged, the pressure
can quickly increase and cause very severe
symptoms.
What are the symptoms of angle
closure glaucoma?
·
Sudden, severe blurring of vision
·
Severe pain in or around the eye
·
Colored halos around lights
·
Red eyes
·
Nausea and vomiting
·
Often occurs in the middle of the night and causes you to wake
up with severe pain
When should I see the eye
doctor?
If
you have any of the symptoms of acute angle closure glaucoma
(see above) you should see the eye doctor immediately. If it
is in the middle of the night and you are unable to see the
eye doctor go to the nearest emergency room. Don’t wait and
expect the eye to recover on its own – it needs emergency
treatment.
Otherwise, you should have regular
exams with your eye doctor. He or she will be able to do
many tests not only to determine if you have glaucoma but also
to inform you if you are at a greater risk than normal for
glaucoma. Remember that it is important to evaluate and
determine the risk for glaucoma -even if you don’t have it
-and to treat it in the early stages before it causes any
vision loss.
How does the doctor test for
glaucoma?
Many tests may be done to test for
glaucoma.
Tonometry – During routine eye exams a
tonometer is used to measure the pressure inside the
eyeball. An abnormally high pressure reading (IOP-intra
ocular pressure) indicates a problem with the amount of fluid
in the eye. Either the eye is producing too much fluid, or
it's not draining properly. Normally, IOP should be below 21
mmHg (millimeters of mercury) though generally the lower the
better. If your IOP is higher than 30 mm Hg, your risk
for glaucoma damage is 40 times greater than if it is 15 mm HG
or lower. Most eye drops are specifically designed to
keep IOP low. However, pressure alone cannot be used to make
the diagnosis because it is possible to have glaucoma even
with normal pressure. Therefore, other tests are also
used to diagnose glaucoma.
Visual field testing is a way to
determine whether blind spots are developing in your
peripheral vision as a result of glaucoma. Some visual field
instruments are specifically designed to be sensitive to the
loss of nerve fibers damaged by glaucoma. To do
the test you look straight ahead into an instrument and click
a button whenever you notice a blinking light in your
peripheral vision.
Optic Nerve Imaging – This can be done
by conventional visible light photography or by scanning laser
polarimetry (GDx) or optical coherence tomography (OCT). The
doctor will also evaluate the optic nerve directly by looking
in your eye with an ophthalmoscope. The Fourier Domain OCT
that I have not only evaluates the thickness of the nerve
fiber layer but also the ganglion cell layer thickness. The
ganglion cells run from the middle part of the brain (lateral
geniculate body) to the inner layer of the retina of the
eye.( So they are as much brain tissue as eye tissue.)
When they are damaged by glaucoma they begin to shrink.
The OCT instrument can detect differences in thickness as
little as one micron - one millionth of a meter- about 1/100
of the thickness of a piece of paper!
Gonioscopy - Specialized lenses may
also be used to determine the structure of the anterior
chamber angle. The presence of a narrow angle increases the
risk for angle closure glaucoma.
Pachymetry – Another test that may be
done is to measure the thickness of the cornea of the
eye. It has been found that an abnormally thin cornea
increases the risk for glaucoma.
How is glaucoma
treated?
Eye
drops with the goal of lowering pressure ( IOP) are usually
tried first to control glaucoma. If drops are ineffective then
surgery or laser, depending upon the severity, may be used.
Because glaucoma is often symptom free and painless you may
become careless about the use of eye drops that control eye
pressure. In fact, failure to use the eye drops as
instructed is a major reason for blindness resulting from
glaucoma.
Special
Offer
Did
you know that Medicare will cover you for a glaucoma screening
if you have any of these risk factors?
·
African Americans aged 50 or more
·
Hispanics aged 65 or more
·
Diabetics
·
History of glaucoma in your family
Additionally, If you are 65 and over
and covered by Medicare call our office for a complimentary
glaucoma screening.
Yours for Better Vision and Eye
Health,
David T. Littlefield, O.D.,
F.A.A.O.
Littlefield Optometry
13014
State Line, Leawood, KS 66209
913-498-1363
www.drlittlefield.com
|