By Judith Whitehead – Contributing Writer
For the most part, glaucoma is an eye disease that damages the optic nerve of the eye and can rob peripheral vision slowly and methodically, without pain.
This is why it is so important to get regular eye exams done by an eye doctor. Either an optometrist or ophthalmologist who is a medical doctor can perform this testing.
The optic nerve has a measurable size that can be detected during an eye examination. The ratio between the “cup” to the “disc” inside the eye determines if you are at risk for developing glaucoma. A person can have risk factors for developing glaucoma and never develop the disease. If the size of the optic nerve is greater than .4 mm, then you have a risk factor. Other risk factors are hereditary causes, injury to the eye, and an elevated intraocular pressure of greater than 21. Glaucoma also is more prevalent among African Americans and older people.
There are many types of glaucoma. The most common open angle glaucoma. There are also closed angle and narrow angle varieties which come on suddenly with symptoms of nausea, headache, brow and eye pain and vision loss.
When these symptoms occur, many people think they are getting the flu. This occurs more often with people that have small eyeballs or are hyperopic or have mature cataracts that have not been removed. This is the type of glaucoma that you see listed on medication bottles that state, “Do not take this medication if you have narrow angle glaucoma.”
Glaucoma can also start with someone who has a normal eye intraocular pressure that is tested in an office and should measure under 21 mm/Hg (mercury). Someone can also get secondary glaucoma from using other medications (for example, steroid drops), and through trauma or other causes.
Someone can be born with congenital glaucoma, which is more rare and detected in infants or small children.
If glaucoma goes undetected, the peripheral vision or side vision is slowly damaged and is permanently lost. Treatment works best after an early diagnosis. Peripheral vision testing – a visual field test done in the office – measures the thickness of the cornea using pachymetry and gonioscopy to measure the angle of flow in the eye and document the shape of the optic nerve. It can be done painlessly and easily with little time commitment.
All these factors put together will determine if treatment is necessary.
Treatment options include drop therapy, a lifelong commitment and not a short-term fix to lower the pressure for the eye to tolerate. Drops can come with side-effects and need to be monitored closely. Some drops, known as beta blockers, can affect blood pressure and breathing. Surgical procedures can be done also to lower ones' eye pressure as well as laser procedures to “open up the narrow angle” of the eye.
Glaucoma is a serious eye condition. It needs to be maintained with compliance of the patient. Many insurance plans can vary in the cost of eye drops and there are many savings cards available to assist in the cost either given to you by your provider or obtained online, using a computer.
Many drug companies have an allotted number of free samples if you are financially compromised. They have toll-free phone numbers for patient outreach. Today, there is no reason a person should let themselves go blind from this treatable disease.
Judith Whitehead, of East Amherst, is a certified ophthalmic technician.