January 3, 2012

January is Glaucoma Awareness Month

By Nikhil Wagle
Eye Surgeons Associates

In the U.S., more than two million individuals are estimated to be living with glaucoma, and that number is expected to increase by 50 percent, to more than three million, by 2020. Glaucoma is an eye disease typically characterized by elevated pressure in the eye, that causes damage to the optic nerve and defects in the field of vision. The increase in eye pressure is caused by a reduction in the ability of fluid to drain from the eye. The cause of this blockage is unknown. However, as eye pressure increases, nerve cells which carry the information we require to see are damaged and gradually begin to die. As these nerve fibers or cells die, loss of vision begins. Usually, peripheral vision or “side” vision is lost first. This often goes unnoticed. Ultimately, central or reading vision is affected. Blindness caused by glaucoma occurs in thousands of people every year and is the most common cause of blindness in African-Americans.

Glaucoma can develop at any age in life from infancy through late life. However, it most often affects those 45 years of age or older. Those most at risk for development of glaucoma are those with one or more of the following: a family history of glaucoma, age over 45, African-American descent, and diabetes mellitus.

Regular dilated eye examinations are required for early detection of glaucoma. When detected early, treatment can generally control glaucoma and prevent loss of vision. During the exam, a painless test to measure eye pressure is performed. The structures of the eye are examined, including the optic nerve. Additionally, tests can be done to detect damage to the field of vision. Visual field tests measure light sensitivity of your eye. Damage to the optic nerve caused by glaucoma produces a distinct pattern of visual field loss. Doctors can use the visual field to detect and follow the course of glaucoma over time.

Some patients can develop glaucoma without ever having a high pressure. In other cases, individuals with elevated eye pressures may never develop glaucoma. Clearly, there are other factors than eye pressure which play a part in the development of disease. The only way to determine if your eye pressure is “normal” for you is by a thorough eye examination and monitoring.

Because glaucoma is a painless disease in most cases, patients are frequently unaware that they have a problem until significant visual loss has already occurred. It has been estimated that fully half of all those with glaucoma are unaware of their diagnosis. Unfortunately, visual loss caused by glaucoma is irreversible.

Current treatments include topical and/or oral medications, laser surgery or conventional surgery. The goal is to lower the eye pressure to help prevent further damage. Research is looking at the genetics of glaucoma, as well as examining certain neurotransmitters to determine the cause. Hopefully, this research will help identify the cause of glaucoma and improve methods of detection and treatment of this insidious and devastating disease.

Nikhil Wagle, M.D. joined Eye Surgeons Associates in 1999 as a glaucoma specialist and comprehensive ophthalmologist. He achieved a fellowship in glaucoma from Duke University Eye Center. Dr. Wagle is board certified and a diplomat of the American Board of Ophthalmology. He sees patients in our Silvis, Rock Island and Bettendorf offices. For more information visit www.esaeyecare.com.