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A CLEAR LOOK AT GLAUCOMA

Q: I'm a 60-year-old woman, and my sister was told she has glaucoma. She has to use drops in her eyes every day. Using them three to four times a day is really hard for her to remember.

Is there anything else she can do? Do I need to worry about my own eyes?

A: Are you worried about your own eyes because you're afraid that glaucoma is genetic? If so, your level of concern for yourself might depend on the type of glaucoma your sister has.

There are two types of glaucoma: open-angle and angle-closure. You didn't indicate what type your sister has, but the most common one is open-angle glaucoma. This type of glaucoma often occurs in sisters and brothers of people who have it. Glaucoma occurs in 1 percent to 2 percent of people over age 40; one-quarter of people with glaucoma don't even realize they have it.

Glaucoma causes the pressure of the fluid inside the eye to increase over time and, if left untreated, can cause tunnel vision and even blindness. Fortunately, early diagnosis and treatment can usually assure lifelong useful vision.

Treatment usually consists of drops in the eyes to relieve the pressure inside the eyeball. Many drugs are now available as eye drops for the treatment of glaucoma. The medication that has been standard treatment for many years is pilocarpine, which needs to be used four times per day. Other drugs can be used three times or even twice a day.

These drugs have side effects and can cause allergies. Your sister may want to discuss with her doctor whether she can use an alternative medication that she doesn't have to take so often.

She may also want to ask about surgery, which is usually recommended when treatment with eye drops is not working very well. Also, a laser treatment called trabeculoplasty is being used more and more frequently. This may be recommended as a means to put off surgery, but some doctors may recommend this treatment very soon after diagnosis.

Here's a tip to help your sister remember to take her eye drops: Tell her to put her drops near the salt and pepper shakers, sugar bowl or anything else she uses many times during the day. Seeing the drops will remind her to take her medicine on time.

As for you, it's important for you to remember that being tested for glaucoma can be very important for every older person, especially if your sister has it. So you need to have eye exams frequently; I recommend every year, so any changes can be followed. You may not want to worry, but you do need to pay close attention to your eyes.

Empower yourself: How often have you, or someone you know, left a doctor's office without understanding a lot of what was said? If you're like most people, the answer is very often. Yet, the key to following up with a health problem is the understanding of and acting on what the doctor has recommended.

I often hear people say that so many doctors just don't take the time to explain things; that they rattle off a lot of technical terms and walk away. Granted, some doctors do just that. But if you follow these few simple guidelines, I'm sure your doctor will take the time to explain everything to your satisfaction:

Tell your doctor at the beginning that you want to learn and understand as much as possible about your condition.

Bring paper and pen to take notes when the doctor is talking to you.

If you don't understand something, even if it's just one word, ask for an explanation.

If anything you hear frightens you or makes you worry, say so.

Before you leave, ask the doctor what you should do if you have questions or become anxious after you leave the office.

Dr. Allen Douma welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Douma in care of Tribune Media Services, 435 N. Michigan Avenue, Suite 1400, Chicago, IL 60611.

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