January is recognized as Glaucoma Awareness Month, a time dedicated to educating the public about this often-overlooked condition that affects millions of people worldwide.
Glaucoma is a group of eye diseases that damage the optic nerve, which is essential for good vision, says Dr. Terry Kwak, an ophthalmologist at The Eye Center in Rockville. He is associated with Shady Grove Hospital Adventist Health Care System.
“Glaucoma can be progressive, causing peripheral vision changes over time if not properly managed,” Kwak says. “Patients can progress to central vision loss, which is irreversible.”
Daily activities such as driving or playing certain sports may become challenging. Losing the ability to see shades of the same color and problems with glare and light sensitivity are some of the possible effects of glaucoma—short of blindness—that may interfere with activities.
The most common type is open-angle glaucoma, which develops gradually and painlessly, often without noticeable symptoms until significant damage has occurred. Another type, angle-closure glaucoma, can appear suddenly and is characterized by severe pain, nausea and blurred vision, requiring immediate medical attention.
“The most common characteristic of glaucoma is elevated eye pressure. However, there may be some individuals who could have normal eye pressure and still have glaucoma,” Kwak says.
Glaucoma tends to afflict people in older age but can happen at a younger age, Kwak says. Some babies can have congenital glaucoma, an uncontrolled eye pressure at birth.
“There are different treatments to diagnose glaucoma and treat eye pressure, which has been shown to decrease the risk of progression,” Kwak says. “So, although many people could go blind, they don’t because of the treatments available.”
Eye drops or minimally invasive glaucoma surgeries can treat glaucoma. In severe cases, more traditional surgeries are necessary, but those can be fraught with complications, he says.
The first step in treatment is to get properly diagnosed through visual field testing, measuring intraocular pressure and assessing the optic nerve for signs of glaucoma.
The American Academy of Ophthalmology recommends that adults have a comprehensive eye exam by age 40. For those at higher risk, exams should occur more frequently, typically every one to two years.
Individuals who have a family history of glaucoma have a higher risk for some types of glaucoma. Older age and being of African and Latino descent can be factors too, Kwak says. People with diabetes and high blood pressure are also at risk as well.
“There are many people who don’t feel anything until it’s too late,” Kwak says. “Vision loss as a result of glaucoma will not come back. Our job is to prevent it from getting worse or slow down the progression.”
Glaucoma patients should be monitored frequently. If well managed, that might mean going to the ophthalmologist twice a year.
Researchers are studying better methods to treat glaucoma and eventually find a cure. They are studying stem cell treatments, but they tend to work on more primitive organs.
“Unfortunately, the eye is considered the most complex and most advanced organ,” Kwak says.
The other area of research is the implantation of microchips into the eye.
“Glaucoma is still a somewhat mysterious disease to us in ophthalmology even though we know millions of people are affected by it in the U.S as well as the world,” Kwak says.
By advocating for regular eye exams and spreading awareness, more people will receive the care they need leading to healthier eyes, he says.
