After a glaucoma diagnosis in her early 40s, Sanja Allen is grateful that she was diligent about getting regular eye exams. Otherwise, the now 56-year-old Allen could be facing irreversible blindness. Allen feels very fortunate that Key-Whitman Eye Center’s Kimberly Warren, M.D. “is in the driver’s seat when it comes to managing my glaucoma.”
After a glaucoma diagnosis in her early 40s, Sanja Allen is grateful that she was diligent about getting regular eye exams. Otherwise, the now 56-year-old Allen could be facing irreversible blindness. Allen feels very fortunate that Kimberly Warren, M.D. “is in the driver’s seat when it comes to managing my glaucoma.”
When she was diagnosed, Allen says, “The scary part, was that at40-years-old, the pressure in my eye had tripled since my last exam. And, I had a lot of damage already. Dr. Warren explained to me how critical it was that we caught it in time. I wasn’t aware of the seriousness behind my glaucoma, but she approached it very aggressively right away and still does today.”
Unfortunately, of the more than 2 million Americans who have glaucoma today, over half don’t event know it, according to the Glaucoma Research Foundation (GRF).
According to Dr. Warren, who specializes in glaucoma management at Key-Whitman, “Primary open angle glaucoma (POAG) is a silent disease, because there are no symptoms early on. Your eyes don’t hurt and early vision changes are very subtle. If left untreated, you will start to lose optic nerve tissue, and eventually the optic nerve can die. Once the nerve is damaged or dies, we don’t have the technology to regenerate it, so there is NO cure.”
POAG is the most common form of glaucoma in the United States, and is expected to affect 3.3 million people in this country by 2020. “When diagnosed early, we can help stop vision loss by preventing the loss of optic nerve tissue. That’s why it’s so important to screen for, detect and treat glaucoma before it progresses,” stresses Dr. Warren.
For some patients, POAG is caused by the increase in the intraocular pressure in the eye. That isn’t always the case, however. “Screening for eye pressure alone is not enough, because many patients with glaucoma have normal eye pressure. We have new technology that we screen by taking a picture of the optic nerve to see how much optic nerve tissue the patient has. We also perform visual field tests to check for peripheral vision loss (or tunnel vision), a key indicator of advancing glaucoma,” Dr. Warren says.
Undergoing regular eye exams to check for glaucoma is vital, especially if you have any of the comorbidities that increase your risk for the disease. According to Dr. Warren, “Common glaucoma comorbidities include age (55 and above) as well as diseases such as diabetes and hypertension. People of African American descent and myopic patients are at higher risk.”
According to the GRF, African Americans should schedule regular glaucoma screenings by age 35, because “glaucoma strikes earlier and progresses faster in African Americans.” The GRF also notes that glaucoma is six to eight times more common in African Americans than Caucasians and it’s the second leading cause of blindness after cataracts.
Dr. Warren also strongly encourages family testing for glaucoma, because “one of the biggest risk factors for glaucoma is when a family member has the disease. In fact, your risk for glaucoma is 20 percent higher if there is a family history of glaucoma. If you or a family member has glaucoma, then everyone in your family needs to be screened to prevent vision loss.”
Prescription eye drops, which help reduce intraocular pressure, are the most common and effective form of treatment for patients with POAG, as long as the patient takes the drops as prescribed and sees his or her eye doctor as directed for follow up visits. Says Dr. Warren, “One of the reasons why glaucoma progresses is because people don’t take their drops.
For patients who are intolerant to drop therapy or dealing with an advanced glaucoma diagnosis, laser surgery is often a viable option. “Selective laser surgery, which is a completely painless, outpatient procedure, takes an eye surgeon only a few minutes to perform. This procedure enables the eye to drain fluid more effectively. Patients who undergo laser surgery typically have a positive response that lowers the intraocular pressure in the eye,” Dr. Warren advises.
Read more and watch a short video about treatments and surgical procedures for glaucoma here.
Dr. Warren is excited about ongoing studies that use microneedles to administer targeted drug therapies for reducing eye pressure. “Hopefully in the near future we’ll have microinjections that we can use before we need to do an intraocular surgery. With microinjections, a much smaller concentration of medication is injected into the eye instead of being administered topically. The hope is that these types of treatments will last longer, we won’t have to worry about patient compliance (as with self-administered drops) and that side effects will be mitigated (redness and irritation for people allergic to preservatives),” she says.
“At the end of the day, the key to preserving eye health and avoiding blindness due to glaucoma is prevention. When people see their eye doctors for an annual eye exam, we can detect the disease early. That way the patient is less likely to get to that point where surgery is necessary, and we can use less invasive, lower-risk procedures to help prevent and stall this blinding eye disease,” Dr. Warren advises.