Glaucoma, leading cause of irreversible blindness, can be detected and treated; get an eye exam every 2-4 years after 40

By Dr. Elham Ghahari
University of Kentucky

Glaucoma is a disease of the optic nerve that can cause vision loss. It is the second leading cause of blindness in the U.S. and the leading cause of irreversible blindness worldwide, and 111.8 million people worldwide will have glaucoma by the year 2040.

Glaucomatous damage is the loss of optic nerve cells, which leads to changes in the head of the optic nerve at the eye, with damage to the field of vision. Glaucoma cannot be cured, but it can be controlled and stabilized with proper treatment.

The most common form of glaucoma is primary, open-angle glaucoma. It is associated with several risk factors such as family history, African ancestry, other eye diseases such as diabetes or inflammation, past eye injury, and elevated eyeball pressure.

High eye pressure is the most important risk factor because it is the only effective target of therapy for glaucoma. Although some forms of glaucoma develop even when the eye pressure is normal, the risk of abnormally high eye pressure increases with age.

Early detection and intervention can help prevent vision loss from glaucoma. However, most patients don’t know they have the disease because it is generally asymptomatic in the early stages, which means symptoms don’t present themselves.

A routine eye exam can identify the risk for glaucoma and early signs of the disease. During an eye exam, glaucomatous optic-nerve damage can be assessed by clinical examination of the optic nerve head and eye pressure can be checked.

The risk of having abnormally high eye pressure as the most important risk factor for glaucoma increases with age. Glaucoma screenings are suggested beginning at age 40 and should continue after that in intervals suggested by your eye doctor, usually every two to four years.

There are usually no early symptoms of glaucoma, so screening exams are very important. Gradual dimming or weakening of vision is sometimes reported. Some patients with acute glaucoma develop severe eye pain and rapid visual changes.

Glaucoma treatment consists of reducing eye pressure using medications, lasers or surgery. Most glaucoma patients can be stabilized with prescription eye drops or in-office laser treatment.

Once the pressure is stabilized, it is important to continue regular follow-ups to make sure the pressure remains low enough. Less frequently, glaucoma surgery may be required.

Elham Ghahari, M.D., is an assistant professor of ophthalmology at UK HealthCare Advanced Eye Care.