While more effective diagnosis methods and treatments have halved the number of people who go blind from glaucoma over the last 30 years, the disorder continues to affect nearly three million Americans and still blinds many. However, regular eye exams are still needed to make sure that any needed treatment can be given as early as possible.
Glaucoma is a group of disorders which can cause optic nerve damage often associated with increasing pressure in the eye. That pressure can build slowly (called open-angle glaucoma) or more quickly (closed- or acute-angle), causing a loss of peripheral vision which can ultimately lead to complete blindness.
Prithvi Sankar, MD, a professor of Clinical Ophthalmology and director of Medical Student Education in the department of Ophthalmology, said many people have open-angle glaucoma, the more common form, and don’t realize it. They could be losing some peripheral vision-but not enough to notice-or they could have no vision loss at all.
That pressure can build up over time and if left unchecked, can cause permanent damage to the optic nerve. Sankar said the outlook is good for patients who come in with very little vision loss or no loss, but any damage to the optic nerve can’t be undone.
Sankar said that in the past, it was impossible to diagnose glaucoma before the vision loss began, but now doctors can get ahead of it, treating the disorder before it ever becomes a noticeable problem.
Treatment is much easier for those who are diagnosed early. Where there was just surgery before, patients have options which include eye drops and laser procedures. There are several new drugs in the research pipeline to help glaucoma sufferers as well. Sankar says these options are effective but still cannot reverse vision loss which is important for those with advancing disease.
The Glaucoma Research Foundation suggests that those at normal risk get checked out every two to four years before the age of 40, one to three years before they turn 54, every year or two from the ages of 55 to 64 and every six months to a year for those 65 and older.
As for the risk factors, Sankar said family history and age both play a role and that glaucoma affects African-Americans more than others. Glaucoma sets in earlier and progresses more quickly in the African-American population, making it the leading cause of blindness among African-Americans.
In 2014, the National Institute of Health gave researchers at Penn’s Scheie Eye Institute, including Joan O’Brien, MD, chair of the department of Ophthalmology at Penn, and Sankar, $11.4 million to study the genetic risk factors which make African-Americans more likely to develop glaucoma than others.
Sankar said that he and his team go into predominantly African-American communities to do screenings and educate about glaucoma. He said it’s important to identify those at risk and make sure they are staying ahead of any permanent damage.