December 1, 2015
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Glaucoma (cont.)

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How often should someone be checked (screened) for glaucoma?

The following are the American Academy of Ophthalmology's recommended intervals for eye exams:

  • Age 20 to 29: Individuals of African descent or with a family history of glaucoma should have an eye examination every 3 to 5 years. Others should have an eye exam at least once during this period.
  • Age 30 to 39: Individuals of African descent or with a family history of glaucoma should have an eye examination every 2 to 4 years. Others should have an eye exam at least twice during this period.
  • Age 40 to 64: Individuals should have an eye examination every 2 to 4 years.
  • Age 65 or older: Individuals should have an eye examination every 1 to 2 years.

These routine screening eye examinations are mandatory since glaucoma usually causes no symptoms (asymptomatic) in its early stages. Once damage to the optic nerve has occurred, it cannot be reversed. Thus, in order to preserve vision, glaucoma must be diagnosed early and followed regularly. Patients with glaucoma need to be aware that it is a lifelong disease. Compliance with scheduled visits to the eye doctor and with prescribed medication regimens offers the best chance for maintaining vision.

What is the treatment for glaucoma?

General approach

Although nerve damage and visual loss from glaucoma cannot usually be reversed, glaucoma is a disease that can generally be controlled. That is, treatment can make the intraocular pressure normal and, therefore, prevent or retard further nerve damage and visual loss. Treatment may involve the use of eyedrop medications, pills (rarely), laser, or incisional surgery.

In the United States, eyedrop medications are usually used first in treating most types of open-angle glaucoma. In contrast, in Europe, laser or surgery is sometimes the first choice of treatment. One or more types of eyedrops may have to be taken up to several times a day to lower intraocular pressure. These drops work either by reducing the production of the aqueous fluid (shutting the faucet) or by increasing the drainage of the fluid out of the eye. Each type of therapy has its benefits and potential complications.

It is important to remember that many patients at risk for glaucoma or who have glaucoma also may have other eye diseases such as cataract or macular degeneration. An ophthalmologist can determine whether any visual loss that one is experiencing is being caused by glaucoma or by other eye abnormalities.

There are many patients whose examination reveals increased risk for glaucoma but no definite evidence of eye damage from glaucoma. These patients have what is termed ocular hypertension (OHT), formerly known as "pre-glaucoma" or "glaucoma suspect." Patients with OHT have no visual field loss but are at increased risk of glaucoma because of the presence of elevated intra-ocular pressure or optic nerve changes visible on ophthalmoscopy or imaging. Some of the patients with OHT require treatment. These patients with OHT need to be observed frequently so that treatment can be initiated prior to the onset of glaucomatous damage.

Medically Reviewed by a Doctor on 9/23/2015


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