Glaucoma is one of the leading causes of blindness in the United States. Although it is more prevalent in adults, it can occur at any age. Glaucoma is a group of eye conditions that damage the optic nerve, which is vital to good vision. While an abnormally high pressure in your eye is one of the known variables, there are other factors that contribute to this condition and thus is considered a multifactorial optic neuropathy.
The most common form of glaucoma called Primary Open Angle Glaucoma is a chronic, progressive, and irreversible condition. While optic nerve damage in the setting of high eye pressure is typical, elevated eye pressure is not necessarily diagnostic for this condition. Many patients demonstrate optic nerve damage despite demonstrating pressure readings within the normal range. This subset of glaucoma is called “normal-tension glaucoma.” As well, there are other types of glaucoma such as angle-closure, exfoliative and pigmentary glaucoma. Therefore, pressure measurement alone is not enough to diagnose glaucoma. Careful examination of the optic nerve with a dilated exam, supplemented by other tests if suspicion is high, is necessary.
While there are many variables leading to glaucomatous optic nerve damage, elevated eye pressure has garnered the greatest attention as it is the one variable that is amenable to treatment. Other factors include age over 40, family history, race (especially African American ethnicity), myopia, medications such as steroids (any route) and presence of systemic microvascular disease such as high blood pressure, diabetes or elevated cholesterol. Still, everyone, even children and young adults, can potentially develop glaucoma. It is estimated that glaucoma is one of the leading cause of irreversible blindness in the United States, second only to macular degeneration.
But unlike macular degeneration which can only be slowed, glaucoma progression can be halted with proper control of the eye pressure in many cases. Generally, chronic topical ocular medications is the solution, but laser treatment as well as minimally invasive surgery with a stent (typically performed in conjunction with cataract surgery) have proven successful in controlling eye pressure. However, advanced stages of glaucoma may require more invasive procedures.
Primary open angle glaucoma is considered the “silent thief of sight” due to its typically slow and chronic progression rate. It has been shown that some patients can have up to 40% damage of the optic nerve without any signs of vision loss, or even visual field constriction. When symptoms do arise, it is certainly too late to recover the nerve function lost. Additionally, the weaker the nerve, the more vulnerable it is to even mild eye pressure elevation which makes halting progression more difficult. The aggressive pressure control required at this late stage often call for multiple topical medications which can make treatment arduous for the patient leading to poor compliance, especially in the elderly.
How can you prevent this silent, irreversible condition?
Since early detection is the key, no matter your age or vision, annual routine eye exams are highly recommended. This is the best avenue to take in order to preserve and maintain the best possible vision.
Many insurances cover yearly eye exams. Medicare part B will cover an annual eye exam if you are diabetic or at high risk for glaucoma. Associated Eye Care is contracted with most major insurance companies although we recommend that you contact your primary or supplemental insurance provider to check for eye care coverage before making an appointment with us.
