Preserving Your Sight
What You Need to Know About Glaucoma
Glaucoma Specialists-Eye Laser Center
Robert M. Kershner, MD, FACS
is a disease of the optic nerve. The
optic nerve carries images from the eye to the brain, allowing one to see.
When the optic nerve is damaged as in glaucoma, peripheral vision, the
vision off to the side of your line of sight, may be lost.
Sometimes the effect is so minimal as to be unnoticeable, and people are
often unaware of the loss of a localized area of vision. If glaucoma goes
undetected or untreated, it is possible for it to progress to complete
blindness. Treatment of glaucoma is aimed at controlling eye pressure.
This is accomplished with medicine in the form of eye drops, but sometimes may
involve the use of lasers or eye surgery.
is at risk for glaucoma? Glaucoma
is common in the elderly. It is
rarely seen in the younger age groups, but people in their 70’s have a 2%
chance of having it, and 4% of those may develop it in their 80’s.
African-Americans tend to develop glaucoma far more commonly than other
ethnic groups. If it’s in your
family, there’s about a 10% chance you too may develop glaucoma.
So if you have a family member with glaucoma-you are at risk and should
have regular eye examinations with an ophthalmologist.
are many forms of glaucoma. The two most common are primary open angle
glaucoma and low tension (“normal pressure”) glaucoma.
Unless the disease is far advanced, most people with glaucoma have no eye
or vision symptoms. Eye pressures
can be much higher (greater than 22mm as measured by a "tonometer"),
than the normal range (18-20mm and may go unnoticed for years.
If an individual feels a sensation of pressure in the eye it is more
likely due to sinus pressure or allergies than
from high pressure in the eye itself.
Visual loss associated with glaucoma tends to progress gradually, over a
period of years, so slowly in fact that most people don’t notice any change at
all. Unfortunately, because the loss of vision from glaucoma is
gradual and without symptoms, the vision that is lost is not recoverable; when
the damage is done, it’s done. The
angle closure form of glaucoma is less common and usually appears as a sudden
rise in pressure, accompanied by blurred vision and pain.
It requires immediate intervention.
Those susceptible include people who are very farsighted or have a family
history of angle closure glaucoma.
sight is the goal of treating glaucoma. Because it is relatively easy to
measure, pressure is the hallmark of glaucoma testing. That is why glaucoma
patients talk about their pressures, which are routinely checked in eye exams. Vision loss is measured by a visual field test, which
measures peripheral vision with an automated computer.
By looking at a screen and pushing a button to signal when a spot of
light is seen, a map of an individual's field of vision can be constructed.
Comparing this map with normal alerts the examiner when there is vision
percent of patients with glaucoma have normal pressures at detection, and
may never have pressures above normal. The
visual field test and examination of the optic nerve are particularly important
in these cases. The optic nerve
normally shows a central depression or “cup”, which can become enlarged in
glaucoma patients as a result of tissue atrophy.
This optic nerve “cupping” can be seen directly by the examining
doctor using a variety of instruments, and its appearance can be recorded with
photographs and other techniques.
only proven treatment for glaucoma is lowering of the intraocular pressure,
and is effective even in cases of normal-pressure glaucoma.
Medication in the form of eyedrops or by mouth can be used to lower eye
pressure, much in the same way a doctor lowers blood pressure with medicine. In
underdeveloped nations, surgery may be used as a first line of defense against
loss of vision, in part due to the expense or lack of availability of
medication. Surgery always carries
some risk of complications, however, which is why it is generally reserved in
this country for more difficult cases. Laser
treatment is a good alternative. Laser
trabeculoplasty, as it is termed, may decrease the eye pressure sufficiently,
and for many people may allow them to eliminate or avoid additional medications
to control their pressure. The
effect of laser may fade over time, which is why anyone with glaucoma needs to
been followed carefully throughout the year to detect a change in the
effectiveness of their treatment.
glaucoma be cured? Though, the
disease may not be eliminated entirely, new treatments are being developed all
the time which are more effective than ever before in reducing eye pressure over
a long period of time. New eyedrops are now effective for once-a-day dosage, making
the treatment more effective without the inconvenience or side effects of
serious a threat is glaucoma to your sight?
The answer is different for each individual.
A Mayo clinic study published three years ago reviewed the files of 295
patients treated there. It was
estimated that people with glaucoma have a 27% chance of going blind in one eye
if they have the disease for 20 years or more.
This frightening statistic must be tempered with the knowledge that we
are now better able to diagnose and treat glaucoma than ever before. For
example, if the patient is 88 years old, and we anticipate the visual field loss
to be slowly progressive over many years, that patient may not require any
treatment. On the other hand, a
40-year-old with visual field loss and high pressures despite medical therapy,
may require surgery to preserve sight. The
recent availability of better medications and improved surgical techniques
promise a new level of hope of treating all forms of glaucoma.
that you know what you need to know, what do you need to do to
preserve your vision? The first step is a comprehensive eye exam by an
eyecare professional. Glaucoma is
diagnosed by examination, not by symptoms. At the Eye Laser Center, Dr. Robert
Kershner and a highly trained staff of medical professionals utilize the latest
technology in the early diagnosis and treatment of this potentially blinding
disease. Our newly acquired HRT (Retinal-Optic Nerve Tomograph) utilizes a
powerful high speed computer to quickly scan the retina and optic nerve and map
out the appearance and contour of the eye's anatomy. Using this test, a
color 3-D image is created and can be analyzed to detect even the slightest
changes to the optic nerve. In many cases, these changes can appear before
they can be detected by your doctor with the naked eye, conventional
equipment and before vision loss can be detected with the visual field
test. This fantastic breakthrough in technology may make earlier diagnosis
a reality. Reduce your risk of losing your sight
and see for the rest of your life. Get
your eyes examined now and make it a regular part of taking care of your health.
Robert M. Kershner, MD, FACS Eye Laser Center, 1925 W. Orange Grove Road, Suite 303, Tucson, AZ 85704-1152, (520)797-2020.
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Robert M. Kershner, M.D., F.A.C.S.
SUITE 303, 1925 W. ORANGE GROVE ROAD
TUCSON, AZ 85704-1152
Phone: (520) 797-2020
Fax: (520) 797-2235
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