By Stephanie Johnson
Mary Ann Lawton didn’t know seventeen years ago that the pain and graininess in her eyes could be a disease. At the time she was working a job that required her to spend hours in front of a computer and she thought her eyes were just being over-worked.
“I finally decided I better go get it checked out,” said Lawton, 76, of Fleming, a patient of Dr. Joseph Cooper’s. “The optometrist I saw at the time didn’t find anything wrong and told me to make sure to keep my eyes moist. A few days later he called me back and told me he wanted me to see an ophthalmologist. That is when I found out that the pressure in my eye was high and I was diagnosed with glaucoma.”
January is National Glaucoma Awareness Month, an important time to spread the word about a disease that causes the loss of sight. Glaucoma is the leading cause of preventable blindness. Everyone, from infants to seniors is vulnerable.
What is glaucoma?
Glaucoma is actually a group of eye diseases that gradually decreases the ability to see. The two main types are open angle glaucoma and closed angle glaucoma.
“Open angle glaucoma is the most common form of the disease,” says Dr. Brenda Jones, MD, an ophthalmologist at Marietta Memorial Hospital. “Most patients show no symptoms early on, but might eventually have problems with seeing lights during dark hours.”
According to the Glaucoma Research Foundation, primary open angle glaucoma happens when the eye’s drainage canals become clogged over time. The inner eye pressure (also called intraocular pressure or IOP) rises because the correct amount of fluid can’t drain out of the eye. With open angle glaucoma, the entrances to the drainage canals are clear and should be working correctly. The clogging problem occurs further inside the drainage canals, similar to a clogged pipe below the drain in a sink.
Most people have no symptoms and no early warning signs. If open angle glaucoma is not diagnosed and treated, it can cause a gradual loss of vision. This type of glaucoma develops slowly and sometimes without noticeable sight loss for many years. It usually responds well to medication, especially if caught early and treated.
“I test any patient over the age of 15 for glaucoma,” said Dr. Jones. “If they have a family history of the disease, I test them earlier.”
Angle closure glaucoma is more rare and is very different from open angle glaucoma in that the eye pressure usually rises very quickly.
“This type of glaucoma comes with severe pain, almost like a tooth ache, with nausea and vomiting,” said Dr. Jones.
With angle closure glaucoma, the iris is not as wide and open as it should be. The outer edge of the iris bunches up over the drainage canals, when the pupil enlarges too much or too quickly. This can happen when entering a dark room.
A simple test can be used to see if your angle is normal and wide or abnormal and narrow. Treatment of angle closure glaucoma usually involves surgery to remove a small portion of the outer edge of the iris. This helps unblock the drainage canals so that the extra fluid can drain. Usually surgery is successful and long lasting. However, you should still receive regular check-ups.
Depending upon the type of glaucoma, treatment may include medication, usually prescription eyedrops, or surgery to lower the pressure in the eye and prevent further damage to the optic nerve. While there is no cure as yet for glaucoma, early diagnosis and continuing treatment can preserve eyesight.
“I’ve been on several different kinds of medication,” said Lawton. “It seems as if my eyes get used to one medication and it no longer works and I have to switch to another. “
Who is at risk?
Glaucoma is the leading cause of blindness among African-Americans. It is six to eight times more common in African-Americans than in Caucasians. It is also much more common among older people. You are six times more likely to get glaucoma if you are over 60 years old. The most common type of glaucoma, primary open angle glaucoma, is hereditary. If members of your immediate family have glaucoma, you are at a much higher risk than the rest of the population.
Some evidence links steroid use to glaucoma. A study reported in the Journal of American Medical Association, March 5, 1997, demonstrated a 40% increase in the incidence of ocular hypertension and open angle glaucoma in adults who require approximately 14 to 35 puffs of steroid inhaler to control asthma. This is a very high dose, only required in cases of severe asthma.
Injury to the eye may cause secondary open angle glaucoma. This type of glaucoma can occur immediately after the injury or years later.
Blunt injuries that “bruise” the eye (called blunt trauma) or injuries that penetrate the eye can damage the eye’s drainage system, leading to traumatic glaucoma.
The most common cause is sports-related injuries such as baseball or boxing.
Both Drs. Cooper and Jones recommend regular eye exams to ensure your eye is healthy.
Lawton has been very good about taking care of the disease and preserving her eyesight. “The most important thing I’ve done is to take care of myself,” she said.
CONTACT: Jennifer Offenberger,
Director of Marketing & Public Relations
Marietta Memorial Hospital
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