Glaucoma… Knowing the Facts Can Save Your Sight Welcome everyone. I’m Dr. ___________________ Today we’re going to learn more about an eye disease often called “The Sneak Thief of Sight,” glaucoma.

How do we see? Let me start our discussion today with providing you with a brief overview of how we see. Light enters through the clear covering of the front of your eye, the cornea. Your cornea bends, or what we as optometrists call ‘refracts’ the rays that pass through a round opening called the pupil. The iris, which is the colored part of your eye, opens and closes to regulate the amount of light passing through. The light rays then pass through the lens, which bends the rays and focuses them on the retina at the back of the eye. Your retina is a thin layer of tissue at the back of your eye that contains millions of tiny nerve cells called rods and cones. They are named for this distinct shapes. Rods provide peripheral or side vision, and also allow your eyes to detect motion and help you see in dim light and at night. Your optic nerve sends these impulses to your brain, where an image is produced.

What is Glaucoma? Group of eye diseases that cause damage to the optic nerve Primary open-angle – most common, develops slowly and painlessly Acute angle-closure – sudden blockage of drainage channels, is an emergency Now let’s talk about glaucoma. Most people think of it as ‘an eye disease,’ but actually, glaucoma is a group of eye diseases that cause damage to the optic nerve, causing what many refer to as ‘tunnel vision.’ The two more common forms of this eye disease include: Primary open-angle – most common, and develops slowly and painlessly so it can gradually destroy vision without any warning signs Acute angle-closure occurs from a sudden blockage of drainage channels, causing rapid pressure build up and is accompanied by - blurred vision - the appearance of colored rings around lights, like halos - pain or redness in the eyes - sometimes accompanied by severe headache and nausea - this is a medical eye emergency

Why should I know about Glaucoma? More than 3 million Americans have glaucoma Nearly half don’t know they have it Vision loss often occurs before individuals are even diagnosed Loss of vision is permanent -- it cannot be reversed Here are some key facts that you should know about glaucoma: First, more than 3 million Americans have glaucoma Unfortunately, nearly half don’t know they have it Vision loss often occurs before individuals are even diagnosed Loss of vision is permanent -- it cannot be reversed

How does Glaucoma damage my eyes? Optic nerve carries visual information from the eye to the brain Optic nerve cells degenerate and die slowly As nerve cells die, vision is slowly lost Vision loss begins in the peripheral, or side vision Vision loss is not recognized until significant amount of nerve damage occurs! That’s why glaucoma is know as the “sneak thief of sight.” Optic nerve carries visual information from the eye to the brain Optic nerve cells degenerate and die slowly As nerve cells die, vision is slowly lost Vision loss begins in the peripheral, or side vision Vision loss is not recognized until significant amount of nerve damage occurs! That’s why glaucoma is know as the “sneak thief of sight.”

In a healthy eye/optic nerve… Acqueous Humor Clear fluid inside of the eye Continuously produced and drained out of the eye If production increases, or draining decreases, glaucoma develops due to increased pressure

Normal Vision

In an eye with glaucoma… Fluid drains too slowly as it exits eye This causes pressure inside the eye to rise Higher pressure leads to deterioration of optic nerve fibers Result is loss of vision Fluid drains too slowly as it exits the eye. This causes the fluid pressure inside the eye to rise. The higher pressure leads to deterioration of optic nerve fibers resulting in loss of vision.

Loss of Peripheral Vision* This slide depicts what someone with vision loss due to optic nerve damage may experience. You’ll see the ‘tunnel’ effect of losing peripheral vision. *However, loss of vision can vary greatly from person to person.

What are the symptoms? No pain or symptoms are present in early stages Loss of peripheral vision typically is first indication No pain or symptoms are present in the early stages Typically, loss of peripheral vision is first indication

Am I at risk? You are at HIGH RISK for glaucoma IF you are: African American over age 40 Over age 60 Have a family history of glaucoma

How is it detected? Tonometry – measurement of pressure in the eye Ophthalmoscopy – examination of back of the eye to look at health and appearance of optic nerve Pachymetry – measurement of thickness of cornea Visual field test – measurement of peripheral vision Laser imaging – OCT or GDX

What precautions can I take? Yearly (or more frequently if you’re at high risk) comprehensive eye exams are your best defense against eye disease Though not a cure, early detection and treatment of glaucoma can slow its progression

What treatments are available? Medication Laser Surgery Surgery How do we treat glaucoma? Medicines, in the form of prescription eye drops or pills, are the most common early treatment for glaucoma. Medications lower the eye pressure while some cause the eye to make less fluid. Be sure to tell your optometrist about other prescription and over-the-counter medications that you are taking, since the prescription eye drops can interfere with the way they work. In some cases, laser surgery may be necessary. Laser treatments for one or both eyes may be performed, usually several days or several weeks apart. Conventional eye surgery makes a new opening for the fluid to leave the eye. Your eye doctor may suggest this treatment, most often after medicines and laser surgery have not controlled the pressure.

Does insurance cover examinations? Most major medical insurance policies, including Medicare, cover annual dilated eye exams for patients at-risk for glaucoma Yearly exams assist in early detection and treatment of glaucoma

For more information on Glaucoma and other eye diseases, please visit: www.aoa.org/patients-and-public

REMEMBER: Yearly, comprehensive eye exams are your best defense against eye disease and vision loss. Schedule an appointment with your optometrist if you haven’t had an eye exam in over a year.

Thank you! Questions? Certain photos and illustration courtesy: National Eye Institute, National Institutes of Health