Healthtips

As some of us reach the age of 40, our risk for many kinds of medical conditions increases. While we may joke about needing reading glasses, or getting longer arms, our increased risk for glaucoma is a very serious health issue. Glaucoma develops when too much fluid pressure builds up inside the eye. This intraocular pressure results in damage to the optic nerve. As the damage continues your vision may worsen. Without treatment, it can cause blindness within a few years.

There are two types of glaucoma. With the most common, open-angle glaucoma, fluid does not drain properly from the eye. Angle-closure glaucoma, also called closed angle or narrow-angle glaucoma is less common. Drainage may be poor because the angle between the iris and the cornea (where a drainage channel for the eye is located) is too narrow. If the pupil opens too widely, narrowing the angle, the flow of fluid through that channel may become blocked. This may cause a sudden build-up of pressure in the eye.

For most people, the first sign of glaucoma is the loss of peripheral, or side vision, which usually goes undetected until late in the disease. Occasionally intraocular pressure can rise to very high levels causing sudden eye pain, headache, blurred vision, or the appearance of halos around lights. Other symptoms requiring immediate medical care include narrowing of vision, vision loss, or an eye which is red or hazy in appearance.

Since most people with glaucoma have no early symptoms or pain from this increased pressure, the only way to diagnose this debilitating disease is by examination by an ophthalmologist. Your doctor will perform a series of painless tests -- eye pressure measurements, dilated eye exams, and sometimes visual field testing -- to check for any changes in your eye or in your vision. Glaucoma is more common in adults over 40, but has been diagnosed in those much younger. It occurs at an earlier age in African Americans and results in a greater loss of vision. If you are over the age of 45 or have a family history of glaucoma, you should have a complete eye exam by an ophthalmologist every one to two years. If you have health problems such as diabetes or are at risk for other eye diseases, you may need to be checked more frequently. Glaucoma cannot be prevented, but if it is diagnosed and treated early, it can be controlled.

Glaucoma treatment may include prescription eye drops, laser or microsurgery. Open-angle glaucoma is most commonly treated with combinations of these three. Traditionally medication has been prescribed first, but there is increasing evidence that laser surgery or microsurgery may work best for certain patients.

Eye drops either reduce the formation of fluid in the front of the eye, or increase its outflow. There are some side effects such as allergy, eye redness or irritation, brief stinging or visual blurring. Some of these medications may affect the heart and lungs. Many people can preserve their vision if they take their medications as scheduled and visit their doctor regularly.

In some cases, however, medications alone do not control the eye pressure, and surgery should be performed. Laser surgery slightly increases the outflow of fluid from the eye in open-angle glaucoma or eliminates fluid blockage in angle-closure glaucoma. There are several types of laser surgery that are prescribed based upon the nature of the blockage. There is also microsurgery, in which your doctor creates a new drainage path in the eye, under the eyelid. Sometimes this form of surgery may need to be repeated. As with any surgery there are some complications that may occur also. After both of these procedures, people may still have to take eye drops to further lower the eye pressure.

The most important statistic about glaucoma is that about half of people suffering from glaucoma don’t know they have it. Doctors cannot reverse damage from glaucoma, but early treatment cuts the risk in half according to a recent study. Just like every other medical condition for which the risk increases with age, preventive care is the key to better health.