OPHTHALMOLOGY

Q: I am a 67-year-old male with 20/20 vision and no family history of any eye disease. I went to the eye doctor a couple years ago and my eye pressure was slightly high. Should I be worried about glaucoma? What are the primary risk factors for glaucoma?

A: Your question is a good one and provides an opportunity to discuss some of the myths about glaucoma. First, a definition: Glaucoma is a chronic eye disease that damages the optic nerve. A healthy optic nerve is necessary for good vision since it transmits information from our eyes to the brain. Glaucoma results in loss of peripheral (side) vision and, if left untreated, can result in blindness.

Myth #1: Having 20/20 vision and no symptoms means you will not develop glaucoma. Glaucoma, the second leading cause of blindness in the world, is often called the ‘silent thief of sight’ because in most cases there are few or no symptoms until noticeable vision loss occurs. Early glaucoma can be determined by your eye doctor’s observation of the appearance of your optic nerve and diagnostic testing. So even if there are no outward symptoms, early glaucoma may be present, and, left untreated, your vision could slowly deteriorate.

Myth #2: Glaucoma affects only the elderly. While it is true that the risk for having glaucoma increases as we age, and that most open-angle glaucoma is age-related, there are other types of glaucoma that can affect people of all ages. Examples include congenital glaucoma (from birth), secondary glaucoma as a result of another eye condition, and pigmentary glaucoma.

Myth #3: Glaucoma only occurs if you have elevated eye pressure. While elevated eye pressure is a major risk factor, glaucoma can also occur with normal pressures and is actually called ‘normal pressure’ or ‘low tension’ glaucoma. Also, not everyone with elevated eye pressure will develop glaucoma. The determining factor is whether or not the optic nerve is damaged from the pressure. Those with higher eye pressures should be monitored on a regular basis as recommended by their eye doctor.

Myth #4: Since there is not a cure for glaucoma, there is no reason to start or continue any treatment. While there is currently no cure for glaucoma, there are effective medications, laser treatments, and surgeries to help control the disease. While glaucoma cannot be cured, it can often be managed and treated particularly when detected in the early stages.

Myth #5: Since no one in my family has glaucoma, I will not get this eye disease. While certain forms of glaucoma are inherited, and having a family history of glaucoma is a risk factor, there are many patients who are the only ones in their family diagnosed with glaucoma. Sometimes there does not appear to be any family history because the history is unknown or not all family members have been examined for glaucoma. It is recommended that all patients diagnosed with glaucoma share this information with their family members and ask them to have a dilated eye exam. Risk factors for developing glaucoma include racial ancestry, age, high eye pressure, severe nearsightedness, and family history.

The most important thing to do for your eye health, particularly if you have any concerns or risk factors for glaucoma, is to have regular, dilated eye exams.

Gregory Eippert, MD

8140 Norton Parkway Mentor, OH 44060 440-255-1115 www.opivision.com