Glaucoma awareness sadly lacking
Glaucoma awareness sadly lacking
BY SHEILA ROBINSON
STAFF WRITER SROBINSON@SWOKNEWS.COM
The Lawton Constitution
Glaucoma is the leading cause of blindness in the United States, according to the Centers for Disease Control, and a special emphasis is being placed on screening and treatment during January, which is National Glaucoma Awareness Month.
About 3 million people have glaucoma and only about half of those know it, according to Dr. Ann Warn.
Warn and Dr. Jean Hausheer of Dean McGee Eye Institute in the Tomlinson Medical Center recommend having your eyes checked by a professional before the damage becomes irreversible.
“We start actually in children and infants looking for it because they can have it, but it’s more prevalent in adults,” Hausheer said. “People that are over 50 really need to have an annual dilated exam by an ophthalmologist to look for glaucoma. You can have it and not have any idea that you have it.”
Glaucoma can be hereditary. It’s a spectrum of diseases that damage that nerve that is in the back part of the eye, according to Hausheer.
A thief in the night
“There’s different types. Sometimes we call it “sneak thief in the night” because it doesn’t have a lot of symptoms to it,” Hausheer said. “I know Dr. Warn and I see it most every day here in our practice. People have no symptoms. They just think they are just coming in for a regular eye exam and have no idea that they have it.”
There are different types of glaucoma that have symptoms; for example, the most common form of glaucoma is called primary open-angle glaucoma. Typically, open-angle glaucoma has no symptoms in its early stages and vision remains normal. As the optic nerve becomes more damaged, blank spots being to appear in the field of vision.
Angle-closure glaucoma, also called closed-angle glaucoma, happens when someone’s iris is very close to the drainage angle in the eye. A closed-angle glaucoma attack is a medical emergency and must be treated immediately. People at risk for developing this glaucoma often have few or no symptoms before the attack.
“That’s the problem with it,” Hausheer said. “You can have a high pressure and not have it or have it. You can have a normal pressure and definitely have it, so it’s not always just about pressure. We have to actually examine them.”
Screening and diagnosis is key
“There’s really not a lot the patient can do to prevent glaucoma. I think diagnosis is key,” Warn said. “It slowly takes your vision, so slowly you don’t even notice it. There’s no pain to it. So sometimes, unfortunately, whenever we diagnose it, there’s already been visual field loss and optic nerve damage.”
Screening and an exam are key, particularly if there is a family history of glaucoma. Those who are extremely farsighted may be at risk, according to Warn.
“Even though it’s one of the top causes of visual loss over the age of 60, it also can be preventable if we catch it early and treat it,” Warn said.
If glaucoma is discovered
“There’s a lot of different treatment parameters depending on the type and severity of glaucoma,” Hausheer said. “Initially, we start with eye medications: antiglaucoma medications, usually an eye drop, sometimes in pills, and we monitor them carefully.”
There are different tiers of treatment for the most common open-angle glaucoma, which usually start with eye drops, according to Warn.
“If those aren’t successful, or there is a reaction to the drops, then we may progress to a laser procedure, which is what we do here,” Warn said. “Then there’s still that small percentage where they are just not controlled with medications or with laser procedures, so we send those to some very good glaucoma specialists we have at Dean McGee Eye Institute in Oklahoma City.”
One of the biggest problems they see is many people delay coming in for an eye exam because they don’t think it’s necessary, according to Hausheer.
“They feel like, ‘I see pretty well.’ That’s the most common thing I think we see,” Hausheer said. “They really need to come in because you can have glaucoma and not have any idea until it’s too late.”
Treatment is important
Warn said they try to impress on patients that medications they prescribe should be used as directed.
“It’s not just an eye drop,” Warn said. “It really can delay progression of glaucoma. That’s the issue we see sometimes, too. People think ‘It’s just an eye drop, maybe I don’t have to take it every day.’ They are specifically for glaucoma. Anything you lose to glaucoma is permanent. We can’t bring it back with surgery or glasses or anything like that. Any optic nerve damage is permanent. Once somebody is diagnosed, then continuing with treatment is imperative to prevent progression.”
Both doctors recommend marking your calendar to make a regular visit to your eye doctor, the same as you would to your physician.
“It can’t be stated enough,” Hausheer said. “Even if you are just wearing those little dime store readers for reading, you need to get your eyes examined because glaucoma happens and people don’t know they have it.”
Most common after age 60
“It’s most common after the age of 60,” Warn said. “I think one of the most tragic things we see is somebody who comes in and they’ve started noticing a visual problem. Maybe they haven’t seen an eye doctor ever, and you look back there and they have very advanced glaucoma. Their problem is their visual field has disappeared. We can’t bring that back. We can just do our very best to keep it from progressing. Early diagnosis and treatment is very key.”
Glaucoma is a pressure that is too high for the person’s optic nerve and that pressure level may be different for each person, according to Warn.
“You make fluid inside your eye, which is called aqueous, and you drain fluid and there is an imbalance there,” Warn said. “The medications that we use either increase production or they increase the draining to try to lower that pressure.”
People who use a lot of over-thecounter eye drops may be getting a signal they should have their eyes examined by a professional, according to Hausheer.
“That’s telling you that something’s itching or something’s burning or something’s blurry or something is uncomfortable,” Hausheer said. “We’re just as happy as June bugs to take a look at anybody. If you are using a lot of eye drops on your own, that’s a signal that you might want to come in and get checked. That’s a safe bet.”
Both doctors agreed many people have problems with allergies and other things that aren’t related to claucoma, but some eye drops have warning labels stating not to use those drops if you have glaucoma.
About the doctors
Jean Hausheer, M.D., practices comprehensive ophthalmology and refractive surgery. She is also a clinical professor for the University of Oklahoma.
Ann Warn, M.D., also practices comprehensive ophthalmology and is an eye physician and surgeon. She is a clinical assistant professor for the University of Oklahoma.