1. Glaucoma Lily T. Im, MD

2. What is glaucoma?   Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness. However, with early detection and treatment, you can often protect your eyes against serious vision loss.

3.  The optic nerve is a bundle of more than 1 million nerve fibers. It connects the retina to the brain. (See diagram above.) The retina is the light- sensitive tissue at the back of the eye. A healthy optic nerve is necessary for good vision.

4. What causes glaucoma?

5.  Flow through drain = Eye pressure Pressure

6. Statistics  ~4 million Americans have glaucoma Only half know they have it  ~120,000 American are blind from glaucoma, accounting for 9-12% of all cases of blindness in the U.S.  Glaucoma accounts for 700,00 doctor visits each year

7. African-Americans  Glaucoma is the leading cause of blindness in African Americans and it occurs on average 10 years earlier and 6-8 times more often than in Caucasians  African-American ages 45-65 are up to 17 times more likely to go blind from glaucoma than Caucasians with glaucoma in the same age group.  The most common form, Open Angle Glaucoma, accounts for 19% of all blindness among Africa-American compared to 6% in Caucasians.

8. Risk Factors for POAG  Race: African Americans over the age of 40  Age: Everyone over the age of 60, especially Mexican Americans  Family History: Positive history for glaucoma. Likely a genetic link.  Medical conditions: Diabetes and Hypothyroidism have been linked.  Other: elevated eye pressure, thin cornea, abnormal optic nerve anatomy

9. Glaucoma Symptoms  Typically NONE.  Vision loss is a late and irreversible symptom.

10. Glaucoma Detection  Comprehensive eye exam to include:  Visual acuity check  Visual field test  Tonometry  Pachymetry  Gonioscopy  Dilated eye exam  Other tests

11. Visual Field

12. Tonometry

13. Pacymetry   Measures thickness of cornea   Thin corneas are a risk factor for glaucoma   Impact how we interpret eye pressure measurements.   Thin corneas underestimate IOP while thick corneas overestimate IOP.

14. Gonioscopy  A special mirrored lens is placed on the eye to visualize the drain in the angle

15. Dilated eye exam

16. Other Tests

17. Treatment  Medicine: drops primarily, rarely oral  Laser  Surgery

18. What you can do…   Take your medicines daily as directed   See your eye physician regularly   Have family members screened

19. Why Screen for Glaucoma? 1. It is an important health problem that can lead to blindness 2. Suitable tests exist that are safe, fast and relatively inexpensive 3. An early asymptomatic stage exists in glaucoma which can be identified and treated to prevent vision loss 4. Acceptable medical and surgical treatments exist for patients with glaucoma 5. The earlier glaucoma is diagnosed and treated, the easier and less expensive it is to control the disease.