January is glaucoma awareness month. It is one of the primary conditions we diagnose and treat in our office. Glaucoma is the second leading cause of sight loss internationally. We call it the silent thief of sight because people don’t realize their sight is diminished until the condition is advanced. Glaucoma is a loss of nerve tissue inside to the eye. Nerve fibers in the eye are like microscopic wires that provide information to the brain about what you are seeing. Each nerve fiber provides a small piece of information to your brain to register what you are seeing. Most of us are born with about 1.5 million of these fibers. It is normal as we age to lose some of them. Fortunately we are born with about 30% more than we need to see things. When nerve fibers are lost it means your brain is getting less information and nerve fibers are lost at an abnormally fast rate. In glaucoma there is a silent slow and painless loss of nerve tissue over months and years. If undetected and untreated sight loss can lead to blindness in the end.
Glaucoma is not just one condition but describes a group of conditions that lead to the same end result which is loss of nerve tissue. Glaucoma can occur at any age but the most common form of glaucoma called open angle glaucoma usually occurs after age 40. The incidence of the condition rises to about 10 percent of the people over age 80. The risk factors for glaucoma include, elevated eye pressure, age, family history, heart disease, ethnicity, poor circulation, sleep apnea, sedentary lifestyle, and poor nutrition. We are all at risk for this condition over time, even without a family history. It used to be thought that almost all cases of glaucoma were caused by elevated eye pressure. It is now known that almost half the glaucoma cases do not have elevated eye pressure.
The diagnosis and treatment of glaucoma has evolved over time. Forty years ago it was thought that is if a person had abnormal eye pressures they should be placed on medication. We now know that most of the time, people with abnormal pressures (with no other signs) do not have glaucoma. Newer technology such as optical coherence tomography and electrodiagnostics such as visually evoked potentials and electroretinogram can detect glaucoma up to 8 years before measurable sight loss can be measured. This has changed how we treat patients.
To prevent sight loss it is recommended that everyone be tested yearly after age 40. If you are a suspect for glaucoma more frequent and specialized tests may be indicated. If you have glaucoma progression of the condition can be slowed or stopped with a host of treatments that are available.
Glaucoma is a condition that silently steals sight until it is in an advanced state. New sophisticated technology has changed glaucoma treatment by helping us make better decisions. There are a variety of options to help people with glaucoma to improve their prognosis. If you have not had your eyes tested for glaucoma in over a year, schedule an appointment to ensure the silent thief of sight (glaucoma) does not rob you of you precious possession. Glaucoma can be controlled if caught early. Early detection is an important factor.