Glaucoma, Is It Getting Worse?

Glaucoma, Is It Getting Worse?
By Tony Marino

Dr. Alan L. Robin, MD They are chilling facts.

If glaucoma is left untreated, a person may go blind.

Half the people who have glaucoma don't even know it.

Glaucoma is the second leading cause of blindness in the United States and the leading cause of blindness in African Americans, Hispanics and Latinos.

These facts may be news to you, but they aren't to 70-year old Ron Payne of Philadelphia, who has seen both his mother and his sister lose their sight to this disease.

Here's another fact: because you have glaucoma, doesn't mean you will go blind.

Ron Payne knows that too.

"My brother Harold is 72 years old and he was diagnosed on the same day as my sister nearly 50 years ago. He has been very diligent about putting in the eye drops that he has been prescribed. His sight is fine today," said Payne.

Harold's vision is still pretty sharp, he's been a photographer most of his life, a profession that demands good vision.

"The Payne family is an excellent example of how this disease can strike," said Dr. Alan L. Robin, a Baltimore glaucoma specialist and an Associate Professor of Ophthalmology at renowned Johns Hopkins University.

"Glaucoma hits families, and is more common in African Americans like the Paynes, but it is a manageable chronic disease if you find out you have it early enough and you take care of it," said Dr. Robin.

If it's not treated, just consider what has happened to Ron Payne's sister

Payne's sister, Barbara was a social worker in New York City before she quit her job to take care of her mother who was also diagnosed with glaucoma late in life. Ironically, like many patients, Barbara was not vigilant in taking her medication and later couldn't afford the drops. Her vision gradually deteriorated until, after her mother had died blind, she too is now severely visually impaired.

GLAUCOMA PATIENTS MUST TAKE CARE OF THEMSELVES

Medical professionals call it "adherence", which is a fancy term for patients doing what they need to do in order keep a chronic disease like glaucoma at bay. What they need to do is to control the intraocular pressure in the eye. Ophthalmologists and optometrists know that if intraocular pressure within the eye can be successfully and continually lowered , the risks for progressive loss of vision are very much reduced.

However, patient compliance with taking the medications is a really big problem.

"One-third of all patients who get a prescription for glaucoma don't even fill it. 40-to-50% of people just stop taking their medicine within the first year" said Dr. Robin. "There are lots of different reasons why people don't use the drops from affordability, forgetfulness, side effects to people who just can't physically put drops in their eye."

Think about it another way; If you forget to take drops one day a week that may not seem like much. But over the course of the year, that's almost two months worth of neglect. The pressure in your eye can fluctuate and the disease worsens. Once that happens, there's no turning back. Any damage to the eye caused by glaucoma is irreversible.

There are other alternatives.

In addition to the drops there are laser treatments and glaucoma surgery alternatives. Dr. Robin said that the SLT (Selective Laser Trabeculoplasty) laser which is made by Lumenis is an example. The treatment, which takes place in the doctor’s office, takes less than five minutes has up to an 80% chance of reducing intraocular pressure, which is the key to treating glaucoma.

HOW BIG OF A PROBLEM IS GLAUCOMA?

The Glaucoma Research Foundation (www.glaucoma.org), based in San Francisco, funds innovative research to find a cure for glaucoma. The Foundation's research is made possible almost entirely by individual private donors. It receives no government funding.

January is Glaucoma Awareness Month, a busy time for the Foundation. The numbers of glaucoma patients are growing, particularly as the population ages. About 2% of the population from the age of 40-to-50 has elevated intraocular pressure, which is a risk factor for glaucoma. That percentage quadruples for people over 70.

And the problem among African Americans is even more pronounced. African Americans between the ages of 45 and 65 are an astonishing 15 times more likely to go blind from glaucoma than Caucasians with glaucoma in the same age group.

"We don't know why African American are so much more prone to the disease than whites," said Dr. Robin. "Not only is the disease more prevalent in blacks, it is also more aggressive. We have to do a better job of early detection."

GETTING A PROPER EYE EXAM

Dr. Robin asks, "When is the last time you had your eyes checked?"

"Just getting checked for glasses is not enough. If you didn't have your eyes dilated by an eye care professional, you haven't been checked for glaucoma. And if you haven't been checked, you won't know you have the disease until a lot of damage has occurred. That's why an annual exam of your eyes is critical."

Ron Payne understands this. His sister Barbara now lives with him. He is the only one of his siblings who doesn't have glaucoma, but he knows even now at the age of 70, he is still at risk. So he gets his eyes checked regularly. It's a good thing he does because if a member of your family has glaucoma, you are four time more likely to contract it.

Payne also is a supporter of the Glaucoma Research Foundation and helps them raise money by telling his family's story.

"Awareness is key," said Payne. "People need to know they have glaucoma and then need to take care of their disease. I've seen what it can do to families, and there's no reason for this to happen."

Dr. Robin agrees. He says the Payne family experience is a cautionary tale.

"Each member of the Payne family tells a story about glaucoma that is important for all of us," said Dr. Robin. "You should be screened by an eye care professional. If you have the disease, then listen to your doctor and treat it. Because if you don’t treat it, you’re going to go blind".

Resource:

  1. The Glaucoma Research Foundation http://www.glaucoma.org
  2. Lumenis, medical lasers, http://www.lumenis.com/
  3. Glaucoma Specialists, Baltimore Maryland http://glaucomaexpert.com/
  4. Wilmer Eye Institute Johns Hopkins http://www.hopkinsmedicine.org/wilmer/
  5. Ron Payne http://psinphilly.com/
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