A DIFFERENT VIEW - Glaucoma a stealthy eye disease


I remember the day clearly.

"You have glaucoma," my eye doctor said. "Put these drops in your eyes three times a day."

The drops greatly increased my nearsightedness, so to be able to drive to work at 7 a.m. and still function throughout the day, I woke at 4 a.m. to apply them. Arriving home after work I would immediately apply them again just before bedtime.

Fortunately, after only a few months of this "torture" I was told I never had glaucoma in the first place and could stop the drops.

But to be sure, my eye pressure was checked daily for a week, then twice the next week then every two weeks for a month.

Still, my doctor had no diagnosis but he did offer to take me to Seattle, where a group of eye specialists were meeting.

We rode from Olympia to Seattle in the doctor's shiny 1955 Thunderbird convertible. For several hours specialists looked in my eyes while plying me with questions.

I heard statements like, "Going to be blind soon," but I refused to even consider this. Why spoil my ride home?

Then I heard one of the specialists say: "Ernie, you don't have glaucoma but you do have severe retina degeneration. It is very important you have your eye pressure checked at least once a year. With your severe nearsightedness, glaucoma would speed up the deterioration of your retinas."

Glaucoma is a group of diseases that cause vision loss or blindness by damaging the optic nerve, responsible for transmitting impulses for sight from the retina to the brain. In most cases damage results from increased pressure in the eye that occurs when fluid that flows in and out of the anterior chamber to bathe and nourish nearby tissue drains out too slowly or suddenly stops.

Besides providing nourishment, this clear, aqueous humor fluid also exerts a constant pressure to help maintain the eyes' shape.

In a healthy eye the excess fluid flows into a channel and into small veins outside the eye.

But when the drainage angle doesn't function properly the pressure inside the eyeball increases, which can cause a gradual loss of vision unless controlled with medication or surgery.

Glaucoma is the second leading cause of blindness in the U.S. and affects nearly 3 million Americans, with most older than age 60. The disease tends to run in families and is five times more common in African-Americans than Caucasians until middle age, when the risk tends to increase with age for everyone.

Open-angle glaucoma is the most common, accounting for 60 to 70 percent of cases. It develops slowly and painlessly when there is too much aqueous humor.

Close-angle glaucoma occurs in about 10 percent of cases and is caused by a partial blockage of the angle, causing a sudden and dramatic increase in eye pressure that requires immediate medical attention.

It is usually accompanied by blurred vision, pain in or around the eye, redness, halos around lights and nausea. It can result from using medications such as cold remedies, anti-depressants and anti-nausea drugs.

Glaucoma usually produces no initial symptoms; vision is normal and there may be no pain. But as the disease progresses you may notice your peripheral vision gradually fading, especially near your nose. As the disease worsens, the field of vision narrows.

In open-angle glaucoma, you may develop "tunnel vision." Your vision narrows so you see only what is directly in front of you, like looking through a tube. Besides reduced peripheral vision, you may notice sensitivity to glare or trouble differentiating between varying shades of light and dark.

Glaucoma cannot be prevented but the earlier it is diagnosed, the greater the likelihood it can be slowed or even stopped with medication before vision is significantly affected. Once detected, eye pressure can be controlled to reach acceptable lower levels and nerve damage may slow or stop, although damage cannot be reversed

Because the gradual vision loss may not be noticed until it is too late, regular eye examinations are important for everyone older than age 40, particularly if there is a family history of glaucoma. African-Americans, diabetics and people with high blood pressure also are at greater risk for glaucoma, as are people who have experienced eye trauma or take corticosteroids and other medications that increase eye pressure.

Prescription eye drops or pills are usually the first line of defense in lowering eye pressure. Laser surgery also may be used if medications are not helpful.

Have you had your eyes examined lately by a professional?

Ernie Jones, a registered nurse who retired due to vision loss, can be reached at 529-9252 or at theolcrow@charter.net.


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