January is National Glaucoma Awareness month. More than two million people are believed to have the eye disease. But in a KERA Health Checkup, glaucoma specialist Dr. Linda Fain Hatton explains why some call it a “silent thief of sight.”
Dr. Hatton: Essentially one out of every two people who have glaucoma, or who are at risk for glaucoma, have no clue that they are. There’s no sign, no symptoms or signs of pain.
Sam: How is that possible? What causes that?
Dr. Hatton: Basically, it’s an increase of pressure within the eye that’s different from blood pressure. It’s eye pressure, intraocular pressure. And it can affect the neurofibril layer and the optic nerve, and damage the nerve, and slowly and silently steal portions of vision. If left untreated, it can lead to blindness.
Sam: But I’m hearing you use the word pressure, so I’m thinking is this not something you fell internally?
Dr. Hatton: No, it has more to do with fluid within the eye that bathes and nourishes the eye.
Sam: There’s no cure for it at this point, I guess?
Dr. Hatton: It’s not a curable disease, but it is a very treatable disease, and that’s what is so essential. Because it might be something as simple as an eye drop in a patient’s eye to keep the pressure as low or lower than it normally would be to reduce damage.
Sam: So what accounts for people going so long without knowing that they have this disease?
Dr. Hatton: Perhaps because, for one thing, our eyes have overlapping visual fields and we might lose tiny bits of peripheral vision in one eye faster than the other. And with the other eye covering that field of view, and no pain association, you know, it could silently stealing portions of sight until it’s noticeable, then it could be a great deal of vision gone. Once the vision is lost, it cannot be recovered. However, patients, if we screen them and know, following them early, certain factors that we can actually measure now that we couldn’t before, we can step in and treat glaucoma. We have several ways to do it. But one of the most simple is simply an eye drop that’s used that reduces pressure.
Sam: What are the other forms of treatment?
Dr. Hatton: There are some surgeries. SLT (Selective laser trabeculoplasty) is a laser treatment that helps reduce flow of fluid. It can reduce pressure. Oftentimes, we’ll do that with patients that can’t be compliant or won’t be compliant, and can help in their lifestyle without having to use a drop every single day. Even cataract surgery a little bit earlier than later has proven to drop intraocular pressure a couple of points. But the main thing is knowing if you’re at risk. If any one in your family or a blood relative (has had the disease). We know for sure Blacks and Hispanics are more highly affected. Typically, we know if we have other health issues - hypertension, diabetes – then those are things that also affect vascular flow and things that can affect the body is more likely to follow. As we get older, we’re more likely to have glaucoma, too.
Sam: So the key is early detection, and after that, the key becomes getting people to go in for an eye exam in the first place.
Dr. Hatton: Right. And it’s really so painless and easy. It’s just there are certain contributory factors for people. For example, an optic nerve might look normal, but if the nerve’s been changing over time, then that’s not normal. And so having a good baseline and having continuity of care. Being able to follow what someone’s optic nerve looks like. Because with glaucoma, as an optic nerve is damaged over time, the appearance begins to change. But optic nerves are as different as snowflakes. So, you have to know was normal for that patient to be able to follow it. It’s a really great thing to have a good annual eye exam, especially over the age of 50. Every other year, I’d say before that. And then the growing years, when we’re children, just because we grow so quickly and our eyes change so quickly.
Sam: Is there research to suggest that we’re close to a cure of any type?
Dr. Hatton: I really don’t know that answer. But we know more about figuring out if patients are gong to develop loss of vision from glaucoma than we’ve ever known. And we can step in quicker and prevent loss of vision.
Dr. Linda Fain Hatton is a certified Glaucoma specialist and CEO of Optix EyeCare and Gallery.
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