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Glaucoma: Millions of Americans Could Go Blind and Half Don’t Know It

After a glaucoma diagnosis in her early 40s, Sanja Allen is grateful that
she was diligent about getting regular eye exams. Otherwise, the now 56-year-old
Allen could be facing irreversible blindness. Allen feels very fortunate that
Key-Whitman Eye Center’s Kimberly Warren, M.D. “is in the driver’s seat when it comes to managing my glaucoma.”
After a glaucoma diagnosis in her early 40s, Sanja Allen is grateful that
she was diligent about getting regular eye exams. Otherwise, the now 56-year-old
Allen could be facing irreversible blindness. Allen feels very fortunate
that Kimberly Warren, M.D. “is in the driver’s seat when it
comes to managing my glaucoma.”

When she was diagnosed, Allen says, “The scary part, was that at
40-years-old, the pressure in my eye had tripled since my last exam. And,
I had a lot of damage already. Dr. Warren explained to me how critical
it was that we caught it in time. I wasn’t aware of the seriousness
behind my glaucoma, but she approached it very aggressively right away
and still does today.”

Unfortunately, of the more than 2 million Americans who have glaucoma today,
over half don’t event know it,
according to the Glaucoma Research Foundation
(GRF).

Glaucoma is a sneaky, silent disease, so early diagnosis is critical

According to Dr. Warren, who specializes in glaucoma management at Key-Whitman, “Primary open angle glaucoma (POAG) is a silent disease, because there are no symptoms early on. Your eyes don’t hurt and
early vision changes are very subtle. If left untreated, you will start
to lose optic nerve tissue, and eventually the optic nerve can die. Once
the nerve is damaged or dies, we don’t have the technology to regenerate
it, so there is NO cure.”

POAG is the most common form of glaucoma in the United States, and is
expected to affect 3.3 million people in this country by 2020. “When diagnosed early, we can help stop
vision loss by preventing the loss of optic nerve tissue. That’s
why it’s so important to screen for, detect and treat glaucoma before
it progresses,” stresses Dr. Warren.

For some patients, POAG is caused by the increase in the intraocular pressure
in the eye. That isn’t always the case, however. “Screening
for eye pressure alone is not enough, because many patients with glaucoma
have normal eye pressure. We have new technology that we screen by taking
a picture of the optic nerve to see how much optic nerve tissue the patient
has. We also perform visual field tests to check for peripheral vision
loss (or tunnel vision), a key indicator of advancing glaucoma,”
Dr. Warren says.

Know your risk factors, African Americans are especially vulnerable

Undergoing regular eye exams to check for glaucoma is vital, especially
if you have any of the comorbidities that increase your risk for the disease.
According to Dr. Warren, “Common glaucoma comorbidities include
age (55 and above) as well as diseases such as diabetes and hypertension.
People of African American descent and myopic patients are at higher risk.”

According to the GRF, African Americans should schedule regular glaucoma
screenings by age 35, because “glaucoma strikes earlier and progresses
faster in African Americans.” The GRF also notes that glaucoma is
six to eight times more common in African Americans than Caucasians and
it’s the second leading cause of blindness after cataracts.

Dr. Warren also strongly encourages family testing for glaucoma, because
“one of the biggest risk factors for glaucoma is when a family member
has the disease. In fact, your risk for glaucoma is 20 percent higher
if there is a family history of glaucoma. If you or a family member has
glaucoma, then everyone in your family needs to be screened to prevent
vision loss.”

Glaucoma treatments continue to evolve

Prescription eye drops, which help reduce intraocular pressure, are the
most common and effective form of treatment for patients with POAG, as
long as the patient takes the drops as prescribed and sees his or her
eye doctor as directed for follow up visits. Says Dr. Warren, “One
of the reasons why glaucoma progresses is because people don’t take
their drops.

For patients who are intolerant to drop therapy or dealing with an advanced
glaucoma diagnosis, laser surgery is often a viable option. “Selective
laser surgery, which is a completely painless, outpatient procedure, takes
an eye surgeon only a few minutes to perform. This procedure enables the
eye to drain fluid more effectively. Patients who undergo laser surgery
typically have a positive response that lowers the intraocular pressure
in the eye,” Dr. Warren advises.

Read more and watch a short video about treatments and surgical procedures
for glaucoma here.

Exciting glaucoma treatment advances are on the horizon, but prevention
is still key

Dr. Warren is excited about ongoing studies that use microneedles to administer
targeted drug therapies for reducing eye pressure. “Hopefully in
the near future we’ll have microinjections that we can use before
we need to do an intraocular surgery. With microinjections, a much smaller
concentration of medication is injected into the eye instead of being
administered topically. The hope is that these types of treatments will
last longer, we won’t have to worry about patient compliance (as
with self-administered drops) and that side effects will be mitigated
(redness and irritation for people allergic to preservatives),” she says.

“At the end of the day, the key to preserving eye health and avoiding
blindness due to glaucoma is prevention. When people see their eye doctors for
an annual eye exam, we can detect the disease early. That way the patient is less likely
to get to that point where surgery is necessary, and we can use less invasive,
lower-risk procedures to help prevent and stall this blinding eye disease,”
Dr. Warren advises.

Posted in: Eye Conditions, Glaucoma

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