The disease, which has not received the attention and publicity of diseases like diabetes, heart disease, and hypertension, has taken the vision of some 120,000 people now living in the United States.
One of the major problems is that many people think glaucoma automatically leads to blindness. Although it is true that there is no cure and that vision impaired by the disease cannot be restored, the progression of the disease, if caught early and properly treated, can usually be halted and sight preserved for a lifetime. The New York-based Glaucoma Foundation, which is leading a national campaign for a greater understanding of the disease, says 90 percent of the people who are blind as a result of glaucoma lost their sight needlessly.
Dr. Kevin C. Greenidge, chairman of the Department of Ophthalmology at the SUNY Health Science Center at Brooklyn and a board member of the Glaucoma Foundation, says that there have been many advances in recent years in treating the disease. "We're finding that glaucoma may be a different disease in people of African descent requiring more aggressive therapies" he says. "Our main aim is to lower the pressure buildup within the eye to slow progression of the disease and save sight."
nyone, at any age, can develop glaucoma. Infants can be born with the disease, and it can develop in small children. The Glaucoma Foundation says 6 percent of the population over 65 has glaucoma. The more significant risk factors a person has the greater the likelihood that the disease will set in at an earlier age.
nyone, at any age, can develop glaucoma. Infants can be born with the disease, and it can develop in small children. The Glaucoma Foundation says 6 percent of the population over 65 has glaucoma. The more significant risk factors a person has the greater the likelihood that the disease will set in at an earlier age.
Dr. Greenidge says "diabetes is a risk factor, and hypertension is a risk factor, and being African-American is a risk factor--and if you have those three--there is a significant chance that you may develop glaucoma and you need to be checked on a regular basis. And if you add to that a family history of glaucoma, you probably have a 50-50 chance of getting glaucoma, if not greater."
A serious problem here is that people, particularly African-American people, wait too long to seek medical attention. "More than 80 percent of the patients who come into my office for the first time are already almost legally blind," he says. "The only thing we can do at that point is to prevent things from getting worse. We can never make it any better." Experts say people of all incomes and backgrounds wait too long before seeking treatment. "We're not talking about granny who just doesn't put on her reading glasses," Dr. Greenidge says. "We are talking about the movers and shakers of the world. Glaucoma happens so slowly and so insidiously that many times people don't realize they are losing their vision until the disease has progressed greatly."
To understand the danger and the need for early treatment, one must have some understanding of how the eye operates. Each eye is controlled by fibers that make up the optic nerve, which carry visual images to the brain. The front compartment of the eye is filled with a watery fluid that nourishes the cornea and the lens, providing them with oxygen and vital nutrients. The fluid also provides the necessary pressure to help maintain the shape of the eye. This pressure is called intraocular pressure. When this pressure is too high, it can put extreme pressure on the optic nerve, damaging it and leading to glaucoma. Most, but not all glaucoma diseases, are characterized by increased fluid pressure in the eye.
Because there are usually no early symptoms, glaucoma must be detected through a comprehensive and painless eye exam. During the exam, the doctor checks fluid pressure in the eyes, examines visions at various distances, and dilates pupils with drops to inspect the optic nerve. Corneal thickness is also measured, and, if needed, the patient's visual field will be checked to measure side vision.
In the early stages, glaucoma is usually treated with daily eye drops to lower the pressure on the eye. Eye drops can actually delay or prevent the onset of glaucoma in people with elevated eye pressure. When eye drops are ineffective, surgery may be needed.
When 72-year-old Louise Hackett was told she had glaucoma about 10 years ago, she was overwhelmed with emotion. "I cried," says the Washington, D.C., resident. "People treat you bad enough when you can see. Lord knows how they would treat you when you're blind."
But once the retired domestic worker realized that having glaucoma wasn't a death sentence or a guarantee that she would go blind, she took on the disease relentlessly. Her medical regimen includes regular doctor visits and eye drops three times a day. As a result, her vision has been stable for the last decade.
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