Glaucoma the Thief of Sight

Glaucoma is a poorly understood disease both amongst the general population and even within the medical community at large. For the layperson, this is chiefly due to the misunderstanding of what the disease is and what it does to vision. For the medical professional it is because the definition of this fairly common blinding disease is constantly changing as research continues to show us more about it. Glaucoma is, for the most part, a slow, but chronic disease that damages your optic nerve. This nerve sends visual signals from the eye to the visual processing centers of the brain. This will result in a loss of what we call the field of vision perceived. It is imperceptible at first, until finally the afflicted patient develops tunnel vision and later complete blindness. This severe debilitation occurs so gradually that in most cases, if left to their own, patients would not recognize the damage and seek medical help until it was too late. Think that is impossible? Well follow me around for a day or so in my clinic and you will quickly change your mind.

The cause of glaucoma is not exactly known at present, although we know of many risk factors that contribute to the progression of the disease such as eye pressure and heredity. Contrary to popular belief, eye pressure elevation is only a risk factor and therefore should not be used to make the diagnosis or if normal to exclude a patient from having glaucoma. Future research, will likely link glaucoma to vascular diseases like strokes. Glaucoma may in fact be a stroke that is in slow motion causing damage over time rather than acutely.

Glaucoma is the second leading cause of blindness in the US and 50% of patients with glaucoma are undiagnosed. Glaucoma is treatable, but not curable, like so many other illnesses such as diabetes. Current screening techniques are inadequate and ophthalmologists without special training in glaucoma may be less likely to suspect the diagnosis when evaluating patients during a general examination. A fairly comprehensive battery of tests is required to evaluate for glaucoma in those presenting on physical examination as suspicious. Suspicion usually arises when the examiner notices abnormal hollowing (cupping) of the optic nerve in the setting of other risk factors. Once diagnosed the only existing treatment is to lower the eye pressure thus allowing improved blood flow into the eye and a slowing of disease progression. This is not a cure but only a treatment. Despite our best efforts at treating some patients will continue towards blindness though this is rare. The earlier we catch the disease; the better usually is the outcome. We currently have many treatments available to lower eye pressure including drops, lasers and surgeries. The best treatment is tailored to each individual patient.

Remember that you are at higher risk for glaucoma if you are older, have a family history, are of African decent, very nearsighted or register high eye pressures. Glaucoma can be treated to minimize visual loss, but it must first be detected and the diagnosis can be at times difficult to make. So please have your eyes checked regularly by a qualified specialist.