By Cheryl L. Dejewski
Glaucoma is known as the “Sneak Thief of Sight” because the most common type is painless and progresses so slowly that most people don’t notice symptoms for years— until severe permanent damage has already occurred. Glaucoma is a leading cause of blindness, especially for blacks. In fact, black Americans have a 6-8 times higher risk rate, and at least one in five age 75 and older has the disease. How can you protect yourself? The partners at Eye Care Specialists, an ophthalmology practice that has focused on caring for Milwaukee’s black community since 1985, advise that you schedule regular eye exams to check for glaucoma, strictly follow eye drop and laser treatment recommendations, and learn the following facts.
How glaucoma affects vision
“The front of your eye is filled with a fluid that supplies nutrients and maintains the eye’s shape. If the proper amount does not continually pump in and drain out, pressure builds up. Glaucoma is a condition in which pressure inside the eye damages the optic nerve (the part of the eye that carries visual information to the brain). If this pressure persists without being diagnosed and treated, it can cause permanent loss of side vision and eventually possibly all sight,” explained Brett Rhode, MD, Head of Ophthalmology at Aurora Sinai Medical Center and senior partner at Eye Care Specialists, a leading local ophthalmology practice that cares for tens of thousands of glaucoma patients.
Daniel Ferguson, MD, an eye surgeon who performs advanced laser and surgical procedures to alleviate glaucoma- related eye pressure, lists the following risk factors for glaucoma:
• Age: Glaucoma is most common in adults over age 40, and the risk increases with age.
• Heredity: People with a sibling or parent who has glaucoma have a 5-10 times greater risk of developing the disease themselves and should be screened every 1-2 years.
• Ethnicity: A black person has a 6-8 times higher risk of going blind from glaucoma than a white person. Hispanics and Asians also have higher risk rates.
• Other factors: Diabetes (doubles the risk of glaucoma), nearsightedness, steroid use, and previous eye injury.
Symptoms and detection
“Since glaucoma and other sight-threatening conditions are typically painless and can progress without symptoms for years, regular eye exams (every two years) are vital after age 40, especially if there is a family history of eye disease,” said Daniel Paskowitz, MD, PhD, an ophthalmologist with credentials from Harvard and Johns Hopkins. A comprehensive exam should include: Ophthalmoscopy (a look inside at the back of the eye to check for signs of glaucoma, like abnormal optic nerve size and loss of pink coloring), Tonometry (a check of inner eye pressure done either with a puff of air or by painlessly touching the eye), Visual Field Testing (to create a computerized “map” of the existing range of sight), Gonioscopy (use of a special lens to look at the drainage angle in the eye), and an OCT laser scan (a painless scan similar to a CT scan to diagnose, track and treat changes to the optic nerve and retina—often before damage occurs).
Dangers of having glaucoma
Glaucoma-related “tunneling” (loss) of side vision makes it difficult to climb stairs, stay in the proper driving lane, detect obstacles, etc. Glaucoma has been shown to increase the risk of having a car accident by up to six times and triples the risk of falling.
Medical treatment (with prescription eye drops)
Glaucoma can’t be cured, but treatment can usually halt further damage and vision loss. The most common type is a lifelong condition that requires continual management with prescription eye drops to lower pressure (by either decreasing fluid production or increasing outflow).
Advanced laser and surgical treatment
“In some cases, when drops alone cannot control pressure, side effects are intolerable, or multiple drops are required, we can offer other options. Advanced laser or new Minimally Invasive Glaucoma Surgery (MIGS) procedures can often be used to increase fluid drainage or decrease fluid production. These procedures take just minutes to perform and are typically covered by Medicare and most insurance plans,” explained Michael Raciti, MD, an eye surgeon who conducts continuing education lectures for fellow doctors and presentations for the general public.
Benefits of advanced laser and surgical treatment
“These advanced procedures are often highly successful at controlling glaucoma and reducing the need for prescription eye drops. This is especially important for people who already have other conditions requiring daily medication(s) that they have to worry about buying, taking and tracking,” said Rhode. “Your eye care specialist can evaluate the need, candidacy and potential benefits of these or other options for your specific case.”
Detection + treatment = vision protection
“Glaucoma-related sight loss is often preventable with prompt diagnosis and care. But all of our expertise, equipment and treatments are of no use if patients don’t come in for check-ups or follow recommended eye drop guidelines,” said David Scheidt, OD, past president of the Milwaukee Optometric Society.
Encourage your siblings and other family members to be checked for glaucoma, especially if one of you has the disease. If any of you do not have an eye care specialist, you can call 414-321-7520 ext. 217 for a free educational booklet and information about scheduling a comprehensive screening (usually covered by insurance or Medicare) at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National Avenue. They also offer information at www.eyecarespecialists.net.
Simple rules to follow for glaucoma
1. Take drops and medications as directed. Do NOT use more or less than prescribed.
2. Keep all eye appointments and use your drops as normal on those days. If you don’t, your pressures may be affected and your doctor won’t be able to tell how you are doing.
3. Schedule your drops and medications around daily routines, such as bedtime and meals to help remember to use them.
4. If you forget to use your eye drops, administer a drop as soon as you remember. Then go back to your regular schedule.