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Tuesday, Feb. 26, 2019

Are You At Risk For Glaucoma?

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Eye exams recommended to prevent vision loss

The short answer is yes. Everyone is at risk for glaucoma. Glaucoma affects almost 3 million people in the United States, and more than half of those patients are not aware that they have the disease. Because glaucoma initially causes loss of peripheral vision, the slowly progressive visual loss often goes unnoticed for many years. To prevent irreversible vision loss and blindness from glaucoma, it is recommended that everyone have a screening eye exam by an ophthalmologist, including measurement of intraocular pressure and examination of the retina, before they turn 40. For patients with risk factors, screening exams should begin even earlier.

What are the risk factors?

• Family history: If a first-degree relative has glaucoma – especially if he or she has required surgery – you have a nine-fold increase in your risk of developing glaucoma. However, 50 percent of patients with glaucoma do not have a family history of the disease.

• Age: Glaucoma occurs more frequently in patients over age 40, but it can happen at any age. Even babies and teenagers may be diagnosed with glaucoma.

• Race: African-American and Hispanic patients are more likely to develop primary open-angle glaucoma, and they are at higher risk for severe vision loss. Asian patients are more likely to have angle closure glaucoma. White patients are at higher risk for pigmentary and pseudoexfoliation glaucoma.

• Other medical conditions: Patients with diabetes and high or low blood pressure should be screened annually for complications that can lead to glaucoma. Chronic steroid use – even joint injections and inhaled steroids – may lead to elevated eye pressure in some patients.

• Other eye conditions: Patients being treated for macular degeneration may rarely experience elevated eye pressures following injections. Previous eye injuries may lead to damage to the drainage area of the eye and cause glaucoma later in life.

What is glaucoma?

There are several types of glaucoma, but they all cause damage to the optic nerve, which sends the signal from the eye to the brain. The common factor is that the eye pressure is too high for the eye. Primary open-angle glaucoma is the most common type of glaucoma and the type that most people think of when they hear the term “glaucoma.” It is more common in older patients and is usually associated with elevated eye pressures that are not high enough to cause eye pain. The peripheral vision is often affected first so most patients will not have symptoms until the disease is very advanced. Angle-closure glaucoma is less common and more severe. It usually causes a sudden rise in eye pressure that can cause permanent vision loss in hours to days. Neovascular glaucoma occurs in patients with medical conditions that lead to decreased blood flow to the eye.

Can glaucoma be treated?

While there is no cure for glaucoma, the good news is that glaucoma is treatable. If caught early, many patients will never develop noticeable vision changes, and most patients will maintain usable vision for their entire lives. Treatment is directed at lowering the eye pressure enough to prevent further vision loss, and there are several ways that we can achieve lower pressures. The firstline treatment is typically eye drops, which are usually well-tolerated and have few side effects. Another initial option for treatment is a minor laser procedure that helps the eye drain fluid better and may delay the need for drops. The next step in the treatment of glaucoma is surgery to either open the drainage area in the eye or to bypass the non-functioning drainage angle with a new filter. We now have many new minimally invasive glaucoma procedures that can be performed in less than 30 minutes and do not require stitches or long recovery periods. Some procedures may even be done at the time of cataract surgery through the same cataract incisions, which allows the surgeon to treat both the cataract and glaucoma with one surgery. With these new procedures, glaucoma care may be customized for the individual, resulting in better outcomes with fewer side effects. It is essential to see your ophthalmologist to be screened for glaucoma because diagnosis is the first step to preserving your vision!

Dr. Holly Guy is a cataract and glaucoma specialist who is trained to medically and surgically treat a variety of eye conditions. She completed her residency in ophthalmology at LSU Shreveport and completed a glaucoma fellowship at Harvard Medical School in Boston. She is accepting new patients. To schedule a consultation, contact Highland Clinic Ophthalmology, 471 Ashley Ridge Blvd., Shreveport, 318-795-4770.

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