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In the Catbird Seat/Joe Kirkish

Glaucoma is the ‘silent thief of sight’

August 1, 2013
The Daily Mining Gazette

There are examples when ignorance is not always bliss, and the development of glaucoma is a most serious one.

Did you know: While glaucoma can strike anyone, the risk is highest for people over 60 and is, along with cataracts, the leading cause of blindness in the United States? But while the onslaught of cataracts can be readily observed, glaucoma is often called the "Silent Thief of Sight" because the most common type of glaucoma typically causes no pain and produces no obvious symptoms until noticeable vision loss occurs.

With glaucoma the silent killer has chiefly to do with pressure.

Increased pressure in the eye damages fiber in the optic nerve, eventually resulting in blind spots or, if not attended to in time, complete blindness.

To explain, simply, at the front of the eye there is a small space called the "anterior chamber." A clear fluid flows through this chamber and bathes and nourishes the nearby tissues. But when the flow is slowed, glaucoma results.

"Open-angle glaucoma" accounts for 90% of glaucoma cases in the United States. It refers to the angle of the area between the iris and cornea through which fluid must normally flow to escape through a spongy meshwork, like a drain. When the fluid reaches the angle and passes through too slowly, it causes a pressure inside the eye to build. If the pressure damages the optic nerve, then open-angle glaucoma occurs and vision loss results.

Nearly 2.2 million people in the United States have glaucoma leading to blindness. While glaucoma can strike anyone, the risk is highest for people over 60. For that reason, as the population continues to age, the number is expected to increase to 3.3 million by 2020.

Also according to statistics, many people of East Asian descent are prone to developing angle closure glaucoma due to the unique make-up of their eyes. And Inuit have a 20 to 40 times higher risk of developing primary angle closure glaucoma. Women are three times more likely than men to develop acute angle closure due to shallower frontal chambers. African-American people are four times more likely to develop primary open-angle glaucoma. Finally, it has been shown that family history poses a serious risk factor for the ailment.

Sadly, there is no cure for glaucoma. While many advances have been made, loss from the disease still cannot be restored. But there are treatments that could save remaining vision. For that reason, early recognition is important.

How can one be assured that glaucoma does not exist or that early stages of glaucoma are present? Your local eye doctor can tell.

A visit to an optometrist or ophthalmologist at least once a year is vital. The standard visit includes, among other tests, the use of what is called a tonometer for pressure detection. Without using technical words, the simplest way to explain any tonometer tests would be to check for how much force is exerted within a certain defined area of the eye.

If the number is below 21, the pressure is considered normal and safe. If it rises to 30, the risk of vision loss from glaucoma is 40 times greater than someone with intraocular pressure of 15 or lower. To diagnose the condition known as low or normal tension requires careful testing including the current state of the art for diagnosis and management of glaucoma called optical coherence tomograpy (OCT) and visual field testing - available locally at the College Avenue Vision Clinic, for example, along with the co-management of difficult or unusual cases of glaucoma with the The Bay Care Clinic in Green Bay.

What should be done when the pressure number is high? Further eye tests are made to determine improvement.

Eye drops can treat a higher pressure. Other methods involve monitoring the disease follow.

The use of sophisticated imaging technology, such as scanning laser polarimetry (SLP), can be used by a specialist to create baseline images and measurements of the eye's optic nerve and internal structures.

Then, at specified intervals, additional images and measurements can be taken to assure that no changes have occurred over time that might indicate progressive glaucoma damage.

A comprehensive battery of visual field tests are another way for an eye doctor to determine if there is continuing vision loss from glaucoma and take an advanced step toward for discontinuing vision loss.

There are advanced eye clinics for complete help in most metropolitan areas, but keeping to our area, there is, for example, the reputable eye clinic in Green Bay - the Bay Care Clinic -which offers everything from early detection to treatment. The clinic has, according to its brochure, "advanced technology and a large, trained staff to perform complete evaluations that measure pressure within the eye, inspect the eye's drainage angles, and test peripheral vision." In addition, it "has the technology to evaluate nerve fiber damage and, thus, identify a glaucoma suspect even before the eye's internal pressure increases." Any action, of course, should be taken, the sooner the better.

And there you have it a layman's exploration into the understanding of the silent killer that is far more pervasive than most of us realize. Ignorance is not always bliss.

Rotten Tomatoes average: "The Wolverine," B-

 
 

 

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