This “thief of sight” is common, especially as we age. But early diagnosis helps glaucoma treatment.
Glaucoma is a group of diseases that damage the optic nerve. These diseases affect about 2.7 million people in the U.S., and the incidence is rising as the population ages. Glaucoma slowly gets worse over time and causes gradual vision loss. Eric Brown, M.D., Ph.D., a specialist with the Vanderbilt Eye Institute, explains what people should know about this common condition.
What are the symptoms of glaucoma?
About half of the people with this common condition go undiagnosed, Brown said, because it does not cause any pain, blurry vision (in the early stages) or double vision.
“It slowly takes away your vision,” Brown said. It can affect one eye more than the other. Someone with glaucoma will typically not even notice a few blurry spots in their vision. Slowly, those blurred spots grow, reducing how much you can clearly see. Often, vision in the center is clear and focused but other areas of the field of vision blur. Sometimes, the person only notices this after the glaucoma has become very advanced.
What are the risk factors?
- The top risk factor is age. Starting around age 40, the risk increases the older we get.
- Race: People of African-American, Asian or Latino descent are at higher risk than Caucasians.
- A family history of the condition.
- Eye pressure, the pressure the fluid behind the cornea exerts on the front of the eye. The higher the pressure, the higher someone’s risk. However, some glaucoma patients have normal eye pressure, and not everyone with high eye pressure develops it. This is the only risk factor patients can control, using medications, laser treatment and surgery. In some people, certain medications can make glaucoma worse.
How is it diagnosed?
Diagnosis usually involves several simple steps:
- A dilated eye exam.
- Checking eye pressure.
- A test of your visual field. Brown joked that the test is “the most boring video game in the world” — patients click a button when they see dim lights. The test reveals the strength of someone’s peripheral vision. The test is painless and takes about five minutes.
- Nerve imaging.
- Monitoring for changes over time.
How is it treated?
“This is not an optics problem,” Brown said — meaning, unfortunately, glasses won’t fix it.
There’s no way to reverse glaucoma’s damage, but treatment can slow or stop its progression if it’s caught early. Treatments include medicated eye drops, laser treatment and surgery. Laser treatment can help the eye naturally drain the fluid better, lowering the pressure and slowing glaucoma. Surgery creates an artificial drain, one that doesn’t rely on the eye’s natural drain, to lower the pressure.
Unfortunately, treatments may cause the side effects of red, itchy eyes. But diagnosis and treatment are important, Brown pointed out, because glaucoma can cause people to lose mobility and independence as vision worsens.
Who should have eyes checked for glaucoma?
If you have a family member with glaucoma, are African-American 50 years or older, are Hispanic 65 years or older, or have a history of diabetes, you should visit an ophthalmologist or optometrist once a year.