Don't Lose Sight of Glaucoma

Vision is our most precious sense. Through sight, we experience the world and its people. Our visual memories stay with us throughout our lives. Glaucoma is a leading cause of blindness. It has no warning, no symptoms and, left undetected, glaucoma steals sight. But with proper care and treatment, glaucoma can be controlled and vision retained.

THE MOST IMPORTANT THING YOU CAN DO TO PROTECT YOUR VISION FROM GLAUCOMA IS TO HAVE REGULAR EYE TESTS. 

EYE TESTS ARE FREE FOR DIABETICS AND CERTAIN RELATIVES OF THOSE WITH GLAUCOMA.
EYE TESTS ARE ALSO FREE FOR PEOPLE ABOVE THE AGE OF 60.

This article is designed to help people with glaucoma and their families, to better understand the disease. It describes the causes, symptoms, diagnosis, and treatment of glaucoma.

WHAT IS GLAUCOMA?

Glaucoma is an eye disease in which the normal fluid pressure inside the eyes slowly rises, leading to damage of the eye's optic at the back of the eye. Open-angle Glaucoma, the most common form of Glaucoma, affects a number of our community members many of whom don't know they have it. It has no symptoms at first. But over the years it can steal your sight. With early treatment, you can often protect your eyes against serious vision loss and blindness.

WHAT CAUSES GLAUCOMA?

At the front of the eye, there is a small space called the anterior chamber. Clear fluid flows in and out of the chamber to bathe and nourish nearby tissues. In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye and loss of vision.  

HOW IS THE FLUID INSIDE MY EYE DIFFERENT FROM TEARS?

The fluid located in the eye is called the aqueous humor. It is different from the tears that your eye makes. Aqueous humor is the clear, watery fluid that is continually produced inside the eye. Tears are produced by glands outside of the eye and moisten the outer surface of the eyeball.

WHAT ARE THE SYMPTOMS OF GLAUCOMA?

1. At first, in the Primary Open Angle Glaucoma there are no symptoms. Vision stays normal, and there is no pain. As glaucoma remains untreated, people may notice that although they see things clearly in front of them, they miss objects to the side and out of the corner of their eye. Without treatment, people with glaucoma may find that they suddenly have no side vision. It may seem as though they are looking through a tunnel. Over time, the remaining forward vision may decrease until there is no vision left.
2. In the Primary Closed Angle Glaucoma condition, the pressure inside the eye rises rapidly and the eye becomes very painful. It is usually red and the vision becomes blurred. The patient may notice haloes around lights. There is often significant headache and occasionally the patient feels very unwell and may even vomit. This condition is very rare in patients under the age of 50 and is more common in people who are long-sighted.
   

The symptoms of other types of glaucoma vary, depending on the underlying cause.

HOW DO I FIND OUT IF I HAVE GLAUCOMA?

The optician can perform a series of simple tests, which will help to determine whether or not you have glaucoma or are especially likely to develop the disease -- even before you have any symptoms. The tests are:

• Visual acuity: This eye chart test measures how well you see at various distances.
  
• Tonometry: This standard test determines the fluid pressure inside the eye. There are many types of tonometry. One type uses a purple light to measure pressure. Another type is the "air puff," test, which measures the resistance of the eye to a puff of air.
  
• Pupil dilation: This examination provides your optician with a better view of the optic nerve to check for signs of damage. To do this he places drops into the eye to dilate (widen) the pupil. After the examination, your close-up vision may remain blurred for several hours. 
  
• Visual Field: This test measures your side (peripheral) vision. It helps your eye care professional find out if you have lost side vision, a sign of glaucoma.

CAN GLAUCOMA BE TREATED?

Yes. Although you will never be cured of glaucoma, treatment often can control it. This makes early diagnosis and treatment important to protect your sight. The aim of the treatment is to lower the eye pressure so as to prevent visual loss. Most doctors use medications for newly diagnosed glaucoma; however, new research findings show that laser surgery is a safe and effective alternative.

WHO IS AT RISK?

Although anyone can get glaucoma, some people are at higher risk than others. They include:

• Everyone over the age of 60 years.
  
• Those with a family history of glaucoma.
  
• Those of African or Asian origin.
  
• Those who are shortsighted. (myopia).
  
• Diabetics sufferers.
  
• Those who are hypertensive.
  
• Long term steroid users.
  
• Those with previous eye injury.
  

IS THERE ANY WAY TO PREVENT GLAUCOMA?

NO. But having regular eye checks will enable early detection and treatment. Everyone should have regular eye checks but especially those in the above categories.

SO YOU HAVE GLAUCOMA, NOW WHAT?

• Get your eyes checked regularly
  
• Take the diagnosis of glaucoma very seriously  
• Do not neglect the care of your eyes
  
• Educate yourself about your type of glaucoma
  
• Educate yourself about possible treatments for your type of glaucoma
  
• Talk to your doctor, ask questions, get answers
  
• Don't be afraid to get a second or even third opinion if you feel the need
  
• Take eye drops as prescribed, hold your tear duct
  
• Know what a visual field is and what your visual field looks like
  
• Lead a healthy lifestyle
  
• Prepare to wait for results, you will soon find out that a great deal of time is spent waiting to see if current therapy is helping. So prepare yourself mentally and try to be patient while you are waiting for results.
  
• Get glaucoma support.
  

ARE YOU A PARENT WITH GLAUCOMA?

As a general rule as long as the intraocular pressures are normal you should have your children seen by the optician:

• Prior to starting kindergarten
  
• Every 2 to 3 years in childhood
  
• Every 2 years in their teens
  
• Every year after that
  

HOW DO YOU COPE WITH GLAUCOMA?

• Get support from friends, family and other patients
  
• Think positive about life, glaucoma is NOT a death sentence
  
• Stop to SEE the roses
  
• See the world...go some place you've never been
  
• Educate yourself about your condition
  
• Play an active role in your treatment plan
  

EXERCISE:

Studies indicate that glaucoma patients who exercise regularly (at least three times a week) can reduce their intraocular pressure by an average of 20%. If they stop exercising for more than two week, pressure increases again. In one study, those who walked briskly four times a week for 40 minutes were able to go off their medications. Closed angle glaucoma is not affected by exercise and in patients with pigmentary glaucoma, pressure may temporarily increase after exercise. (Although not confirmed by any evidence, yoga or other exercises which involve head-down or inverted positions may be harmful for glaucoma patients and should be discussed with the doctor.) It should be noted that vigorous high-impact exercise may cause more pigment to be released from the iris in patients with pigmentary glaucoma. Patients should talk to their doctor about an appropriate exercise program.

DIET:

Vitamins and minerals that are important to the eye include the antioxidant vitamins C, E, and A and zinc and copper. Although no evidence exists that supplements will prevent or treat glaucoma, some studies indicate that vitamin E improved visual fields in patients. Some studies have shown that large amounts of caffeine drunk in a short period of time can elevate eye pressure for up to three hours. Most studies show no impact from caffeine, but glaucoma patients should, to be safe, limit caffeine to low or moderate levels. Drinking large amounts (a quart or more) of any liquid within a short time -- about half an hour -- appears to increase pressure. Patients with glaucoma should have plenty of fluids, but they should drink them in small amounts over the course of a day.

NONTRADITIONAL TREATMENTS:

Meditation, biofeedback, and relaxation methods can help counteract stress and there are some reports that they may help some people with open-angle glaucoma. A number of herbal and non-traditional remedies have been advertised as glaucoma remedies. People should be very cautious about such treatments and discuss them with their doctor. For example, bilberry -- a European blueberry -- is sold in natural food stores as a glaucoma remedy; studies indicate that it may help some people improve night vision and glare, but it is not effective at all in preventing or treating glaucoma. High doses of any so-called natural medicines are usually no safer than traditional drugs, and because of the lack of manufacturing standards and knowledge about toxicity or interactions with other drugs, they may even be more dangerous. No one should undergo such therapies without consulting their doctor.

HIB - Health Advice