Guest Blog by Katherine Mastrota, MS, OD, FAAO, Dipl ABO
Glaucoma affects nearly 3 million Americans and more than 60 million people around the world1. As one of the leading causes of blindness, with no known cure and few early symptoms, awareness of glaucoma may be the best first step towards preventing the disease.
1) What is glaucoma?
Glaucoma is a disease process in which damage occurs to the nerve fibers that form the optic nerve of the eye.
The volume of the eye is a balanced system. Structures within the eye produce a fluid that nourishes the eye and keeps its volume. As the fluid fills the eye, there is an equal and opposite drainage of the fluid that keeps the pressure within the eyeball stable to maintain its shape.
When the amount of fluid produced is out of balance with the fluid being drained, pressure within the eye increases and gradually, but consistently, causes optic nerve fiber death. Ultimately, progressive death of these nerve fibers leads to potentially profound visual loss.
2) Who is at risk for glaucoma?
Although we have a lot of information about the glaucoma disease process, there are significant gaps in our understanding of this common, blinding disease.
For some, glaucomatous-like vision loss occurs with eye pressure that is considered within the normal range for most people. This type of glaucoma, known as normal tension or normotensive glaucoma, reveals that other factors are at play in glaucoma. Some of these factors may include the amount of blood flow to the eye or fragility in the structures of the eye itself.
Risk factors for glaucoma may include age, race, family ocular history, amount of refractive error and eye shape, congenital ocular dystrophies or systemic syndromes, medications, chronic ocular inflammation, and ocular trauma or surgery, among others.
3) Does glaucoma have any symptoms?
The progression of glaucoma is very slow which means you may not even notice the mounting vision decay until the loss is advanced. Unfortunately, the vision that is lost cannot be recovered. Due to the diversity of risk factors and the heavy influence of age on other eye disorders, symptoms of glaucoma may be coupled with those of other ocular diseases such as age-related macular degeneration, dry eye, and cataracts2. It is therefore important to speak with your doctor if you see any change in your vision or if you have persistent eye discomfort.
4) Are there treatments for glaucoma?
Glaucoma treatment focuses on returning the pressure in the eye back into balance. Remember, the fluid produced needs to balance the fluid drained in our closed eye system to maintain the eye’s volume.
The use of eye drops to lower the pressure of the eye is the mainstay of initial therapy; however, there are other avenues of treatment aimed at lowering intraocular pressure. These include laser therapy, oral medications or eye surgery in difficult-to-treat or advanced cases of glaucoma.
Some glaucoma treatments, coupled with the effects of aging, can make you more susceptible to ocular surface diseases such as dry eye2. Talk to your doctor about your personalized treatment plan. Artificial tears, punctal plugs or other prescription therapies may be used to manage your symptoms.
5) Is there a way to prevent glaucoma?
Although there is no sure way to prevent glaucoma, attention to maintenance of a healthy lifestyle and diet may help reduce the impact of disease. The best way to approach glaucoma is to be sure to keep your routine eye exam appointments so that your doctor can assess for early signs of a glaucomatous process. As with most diseases, early recognition and management can yield better visual outcomes in the long run.
Dr. Mastrota is the Program Chair of the Anterior Segment Section of the American Academy of Optometry and has lectured nationally on ocular surface disease.