by Joseph J. Neff
A leading cause of preventable and irreversible blindness is the eye disease glaucoma, which destroys vision by causing permanent damage to the optic nerve. African-Americans seem to have an especially high susceptibility to this so-called “silent” eye disease. Others in the high-risk group include relatives of people who have glaucoma and people who are diabetic. I am writing this article with the hope that my readers will inform others that early glaucoma detection and life-long treatment can prevent blindness.
Your glaucoma tests should begin at age 35 to 40, and continue every two years thereafter. Since age increases your risk of contracting glaucoma, you should have an annual glaucoma exam each year, starting at age 60. The exam is painless and not time-intensive, and should include an eye pressure test and dilation of the pupil to examine the optic nerve.
In mid-1994, at age 59, I learned that I was legally blind in both eyes from low tension, normal pressure glaucoma. Normal intraocular pressure had destroyed most of my optic nerve.
First I was afraid. Then I was angry — why me? Then I resolved to take any actions I could to learn as much as possible about glaucoma. Initially, I was told by an ophthalmologist that I would be totally blind in six months to two years. Five years later, I have experienced some additional vision loss, but I can see relatively well with my remaining vision, and I can do most of the things I want to do. Eye drops and a series of eye surgeries have delayed my subsequent vision loss.
My form of glaucoma, normal pressure or low tension, is the form of the disease that is experienced by up to 45 percent of people with glaucoma, which can result in significant optic nerve damage. Mine was not caught in time, even though I had had an annual eye exam, including eye pressure measurement, since age 30. Fortunately, because of the efforts of many medical researchers, medications and surgeries to reduce intraocular eye pressure have delayed catastrophic vision loss for me.
With glaucoma, there is no pain. There are no early warning signals. Vision loss progresses from the gradual loss of side vision to the final stages, central vision loss. Until recently, many ophthalmologists believed that the intraocular pressure test would detect glaucoma, but this is true for only about 55 percent of people with the disease. For the other 45 percent — like me — intraocular eye pressure is normal, and damage can only be detected by examining the optic nerves, or by administering visual field tests.
Glaucoma is not caused by something that you or your parents did wrong. It is not contagious. You can’t tell someone has it by looking at the front of their eyes. It is often caused by genes that were present in a parent or grandparent. You cannot get glaucoma by reading in poor light, eating an improper diet, or wearing contact lenses. It is possible to develop glaucoma as a result of an eye injury, but this is not a usual occurrence. Treatment can prevent additional vision loss, but it can’t restore lost vision. For now there is no cure for glaucoma-damaged optic nerves, but there is prevention.
Since glaucoma comes from our genes, that means certain groups are more likely to get the disease. For African-Americans, glaucoma is the number one cause of blindness. African-Americans are five times more likely to get glaucoma than any other ethnic group, and with glaucoma they are four times more likely to become blind. It doesn’t do any good to blame anyone because no one is to blame.
It is unfortunate that the group often least able to afford the costs of early detection, lifelong medications and possible surgeries is the group with the highest genetic risk.
For the past year, as a member of the Glaucoma Research Foundation Volunteer Speakers’ Bureau, I’ve had the opportunity to speak before senior citizen groups on early detection and treatment of glaucoma. From audience feedback, I’ve learned that people who are covered by Medicaid have the advantage of paid health care and prescription coverage. People with Medicare must pay for 20 percent of their own doctor costs and 100 percent of their prescription costs.
Glaucoma often requires treatment with two types of drops daily for the rest of one’s life, as well as possible eye surgery to reduce intraocular pressure. The costs of these treatments are not insignificant, especially for people on Social Security.
Fortunately, there are local organizations in many cities who provide low cost or no cost early screening for glaucoma. If there’s a teaching hospital in your city, the facility probably conducts a free glaucoma detection clinic several times each year. For information about low-cost screening programs for low-income individuals, call Vision USA at (800) 766-4466. I also recommend contacting your local church pastor to obtain names of social services organizations which might be able to help defray the costs of these sight-saving examinations. For more information about glaucoma, call the Glaucoma Research Foundation at (800) 826-6693.
Optic nerve damage from glaucoma is permanent, but blindness can be prevented by early detection and treatment to lower eye pressure. We can all make a difference by asking our family members and friends this question: “Have you had a glaucoma exam recently?”