Disease Diagnosis/Management

Glaucoma

Glaucoma: Glaucoma is a disease that damages the optic nerve, and is the most common cause of blindness in the USA. Most loss of vision from glaucoma is preventable if the disease is treated early enough.

Glaucoma is known as the silent thief of vision for good reasons. Over 90% of cases of glaucoma are of a variety that may have no signs or symptoms because peripheral vision can be lost before a person's central vision is affected. Many people are unaware they are losing vision until less than 20% of their visual field remains. This can frequently be prevented by a simple test for glaucoma routinely performed as part of a complete eye examination.

Glaucoma is a leading cause of blindness in adults in the world; one estimate claims nearly 68 million persons worldwide with almost 7 million becoming bilaterally blind. Unfortunately, nearly 50% of people with glaucoma may go undetected until they have lost substantial vision. With the increasing risk of glaucoma with age, this is especially important for the elderly population. The estimated percent of the population in the USA over 65 is expected to more than double within the next few years. The number of new glaucoma cases is expected to proportionally increase. The importance of obtaining a full medical eye evaluation, including a glaucoma check, is advised for anyone over the age of 40. Many cases of glaucoma may take years to show signs of visual loss. The goal is to detect glaucoma at the earliest stage so that appropriate medical and surgical therapy may prevent visual loss.

Diagnosis of Glaucoma:There are three important factors in the diagnosis of glaucoma: intraocular pressure (the pressure inside the eye), the condition of the optic nerve, and the patient's visual field.

In the case of open angle glaucoma, pressure builds up slowly over many months or even years. Glaucoma can also occur with normal eye pressure. There is generally no pain, redness or blurred vision, and in the early and middle stages, patients may not realize that they have glaucoma, unless they receive regular eye examinations.

The doctor will also check the condition of the optic nerve, looking for the telltale paleness and indentation that may indicate glaucoma. Once vision is lost due to optic nerve damage, it cannot be restored: current glaucoma treatments aim to stop or slow further loss of vision by reducing pressure.

Typical early vision loss caused by glaucoma begins in the side, or peripheral vision. A large amount of side vision can be lost before the patient notices, and by this stage, the glaucoma may be very advanced, and it may be difficult to prevent further vision loss. A careful visual field examination, may well identify loss of peripheral vision before the patient notices, allowing early treatment of the glaucoma.

We always monitor for glaucoma during routine eye examinations. Tests include checking the pressure of the eye, screening for peripheral vision defects and analyzing the appearance of the optic nerve. If you are diagnosed with glaucoma, we typically prescribe medications that lower the eye pressure. Most forms of glaucoma are successfully treated with eye drops. Laser treatments and eye surgery are secondary treatments that offer alternative ways to treat more advanced glaucoma.   Although there is no cure for glaucoma…YET, we manage each individual condition very closely to ensure that there is no progression of the disease.

Diabetes:Diabetic patients should have a dilated retinal examination each year. Laser treatments have proven to slow the progression of retinal eye disease for many patients. Diabetes often stimulates the growth of new blood vessels in the back of the eye, which ultimately leak and damage the retina. If this condition is discovered early, laser treatment can destroy these vessels. We have the latest instruments used to detect changes in the back of the eye. If we discover advancing diabetic eye disease that can be treated or needs further evaluation, we will refer you for consultation and further testing to a board certified retinal specialist as well as maintaining constant correspondence with the primary care physician involved in the diabetic care.

Macular Degeneration: Age related macular degeneration (ARMD) is a disease of the eyes caused by the deterioration of the central portion of the retina, known as the macula. The macula is the area responsible for central vision. Early symptoms of ARMD can include distortion, causing lines to appear wavy, and blurring in your central vision, causing difficulty in reading, driving, and recognizing faces. ARMD is the leading cause of blindness in adults, and there is no cure. The effects of this disease are both permanent and irreversible.

The Importance of Understanding Risk

Because ARMD is so debilitating, it’s important to understand what puts you at risk. Risk reduction can begin now, even if you are in your twenties. Don’t wait until you develop symptoms of ARMD. Subtle symptoms can be present long before you notice any change in your vision, but by then it’s too late.

Known Major Risk Factors

  • Family history of macular degeneration
  • Smoking (Even if you have quit)
  • Low Macular Pigment
    Other Important Risk Factors That Are Considered
  • Having light skin and light eyes
  • Having had unprotected exposure to the sun
  • Being Overweight
  • Gender – Females are more at risk
  • Diet – especially one that is low in consumption of foods containing zeaxanthin and lutein (dark, leafy green vegetables like kale, spinach and broccoli, and other foods like carrots, orange peppers, and corn)

Click here to return to Disease Diagnosis/Management choices