No one needs to go blind from this disease
Glaucoma is a disease of the eye that affects the optic nerve, which is the nerve that helps
us to see better, and there are many kinds of Glaucoma’s, so it’s a misconception
that it’s just one disease and another thing to know about the disease is it can affect
people of all age groups, though it is far more common as we get older. Here in the U.S.
the open-angle kind of Glaucoma, is the more common variety, and it is called the silent
thief of sight, because it does not give any symptoms early on. So by the time a person
starts noticing any visual problems, the disease is fairly advanced.
It is a disease of aging, so anyone over the age of 50 or 60, and if there’s a family
history perhaps by the time they’re 45, they should be getting a dilated eye exam
and getting their eye pressure checked, and that would give an indication if there’s
any evidence of damage to the optic nerve or if the eye pressure is high, that is a
risk factor that can cause further damage to the optic nerve. This disease is far more
common in African-American’s and Hispanics than in the Caucasian population. Also it
is a worse form of the disease in African-American’s and Hispanics. Even though it’s a disease
of aging it can also be seen in a newborn baby, also if someone has had trauma to an
eye that puts them at a higher risk of Glaucoma, that’s a different kind of Glaucoma, also
someone who’s using steroids, whether it is for Bronchial Asthma or Rheumatoid Arthritis
or even a skin cream for Eczema, if they keep using it for several years, that puts them
at risk of having high eye pressure.
Even though it’s not curable, it can be well controlled, the crucial thing to know
is, getting screened for it, so my advice to my patients is, “if you have a sibling
or a parent who hasn’t had an eye exam, it’s a good time for them to get it checked
out, especially if they are at 45 or older.
There are many kinds of Glaucoma’s so the more common kind is the open-angled Glaucoma,
which is, most of the times there are no symptoms early on, and as time goes by a person may
have difficulty navigating objects. Even, especially if they are in unfamiliar surroundings,
they might have difficulty and they might bounce into, bump into furniture, or while
driving they may not notice a car changing lanes from either side of them, so because
it’s the peripheral vision, or the side vision that is affected, that’s where they
start noticing those problems. And the other kind is the angle-closure or the closed-angle
Glaucoma, where the drainage system is shut down, and that’s the kind of Glaucoma where
the patient will have symptoms. They may have a bad headache, red-eye, pain in and around
the eye, nausea, vomiting, reduced vision – that is a serious condition and it is
a true emergency, that’s the kind of patient who needs to be seen within hours and they
can be treated with laser, otherwise they take the risk of losing their eyesight all
together and going blind.
Looking at it from the front, which is the cornea, which is the clear part of the eye,
and as you look all the way to the back that’s the optic nerve which is running from the
eye, eye, all the way to the brain. So if you can imagine, it is like an electrical
cable going from the eye to the brain, sending signals whenever you see an object, it sends
the image of that object to the brain and the brain tells you what you are seeing. Right
behind the cornea is your iris and the area where the iris and the cornea meet is the
drainage system, and that is what gets affected in Glaucoma. So if that area is narrowed,
it’s the narrow-angled Glaucoma; if it is wide open, it is the open-angle Glaucoma.
The drainage system runs around in a circular fashion, all-around, right where the cornea
meets the iris, and as aging occurs that drainage system, if you can imagine it’s like a sive,
so with passing of time that sive gets clogged up, and as it gets clogged up, the eye which
normally produces fluid 24 hours a day, there is no way for the fluid to be draining outside,
and that causes a pressure build up, that gets transmitted to the back of the eye and
through the nerve, which eventually gets effected because of the high pressure.
The least invasive is using eye-drops and there are many different good eye drops available.
Usually we start with one eye drop, it works pretty good and after awhile as we get older
it may not be enough, then I add a second eye drop and then a third eye drop. Sometimes
patients are not able to tolerate it because they may have some allergy to the medication
or it may not be adequate. Then we bump to the next level, which would be a laser procedure,
which is done in the office or it might be an eye surgery which is done in the operating
room. As far as the laser goes, it’s a short procedure done in the office, painless, it
takes a few minutes to do and the patient can go home the very same day, get back to
their routine life. As far as the surgery goes there are many different kinds of options.
There is a standard procedure called, a filter, or a Trabelectome, there are tubes that can
be placed, and then there is newer technology called the Trabectome, which is a minimally
invasive procedure.
Also know that if it’s under good control, there’s no reason why any, if not most patients
can’t retain all there good eyesight for all their lives. So I, it’s, it’s tragic
that some people end up losing their eyesight to Glaucoma, because of late diagnosis or
not being adequately controlled with treatment.