Like hypertension, glaucoma is a nasty disease.
It develops without causing obvious symptoms to the typical person, but the implications are devastating: it could actually result in blindness.
It affects 6 percent of Caucasians over the age of 70, with a big increase every decade. Older African Americans are essentially the most affected, accounting for 17 percent, while people of Asian descent seem like essentially the most affected. Relatively safeThis disease affects only three percent of their population.
Does this mean we shouldn't worry about glaucoma before we reach a decent age? Certainly not, especially if it has affected a member of the family, reminiscent of a father, mother, sibling or grandparent.
Ask Brian, who has never seen it.
Some alarm bells
Brian's name is fictitious on this case, but he has a really real story. He is a 45-year-old black man. He is healthy, takes no medication, and works as a forklift operator in a warehouse. Brian noticed that lately, he had occasionally hit things together with his machine but those minor incidents were attributable to poor lighting or lack of focus. He took no motion until his supervisor asked him to take a visible exam.
Brian thought it was a superb idea, especially since he was having a tough time reading the acquisition orders and other paperwork required for his job. He had never been examined before and had never worn glasses. Since he was adopted, he was not aware of eye diseases in his family.
When he presented himself in January at a non-public clinic where I occasionally practice, he was quite confident in his vision. To his surprise, I not only made him read the letters on the chart but additionally conducted several tests. Each time they appeared, he needed to discover the lights appearing in a big dome. The within his eye was photographed and examined under a microscope.
Then the optometric diagnosis was made: Brian suspected glaucoma, a term he had never heard before and which sounded quite scary when said out loud.
It is a disease. which is considered hereditary.Although many other types of contracture can occur – for instance after surgery or other trauma or attributable to the unintended effects of medication. Without treatment, it is known A disease that can make you blind..
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Narrow field of regard
Although symptoms may remain hidden until the disease is in its late stages, visible clinical signs could be detected when an eye fixed health examination is performed by a certified eye health skilled. Clinical signs can appear at any age but are more common after age 50.
By its nature, glaucoma is taken into account a progressive optic neuropathy, characterised by degeneration of retinal ganglion cells and Physiological changes in the optic nerve.
In addition to age and ethnic origin, A significant risk factor has increased “Intraocular Pressure”. This could be attributable to an overproduction of aqueous humor in the attention, or because of this of a restriction of the traditional flow of the attention. An examination by an ophthalmologist or optometrist (depending on the jurisdiction) will determine which procedure is involved and help determine essentially the most appropriate treatment.
Clinical tests also goal the visual field, where glaucoma could also be most evident. As the disease progresses, more nerve fibers are affected, leading to a reduced field of regard for the patient.
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Imaging tests are increasingly being complemented by evaluation of nerve fibers and optic nerve layers using optical coherence tomography (OCT). By comparing a patient's scan with a database matched for age and race, Early detection of glaucoma attacks is possible. Before there's any lack of visual field. Some OCT tests also allow us to acquire images of structures in the attention that may negatively affect the circulation of the aqueous humor, a fluid within the structure of the attention that supports the lens.
Finally, the structure of the attention is examined using a biomicroscope (slit lamp), with special lenses or magnifying glasses (gonoscope).
In Brian's case, his visual nerves were questionable. Intraocular pressure was high, 28 mm Hg in each eye. (A pressure of lower than 20 mm Hg is mostly considered normal.) All other ocular structures were considered normal.
Treatment options
After the diagnosis was confirmed, it was vital for Brian to know that no treatment will cure glaucoma, but we are able to slow its progression to limit the negative consequences on acuity and vision. Once you've gotten glaucoma, you've gotten it for all times and adherence to treatment is critical to maintaining vision.
Treatment often begins with topical medications that either reduce the production of aqueous humor or promote its removal from the attention, or each. Some other medications may protect the optic nerve from damage attributable to glaucoma.
Once drug treatment is began, it should never be stopped without the recommendation of knowledgeable. Any unintended effects, reminiscent of redness, dry eyes or severe irritation, must also be reported in order that they could be treated or prescriptions modified.
An ophthalmologist might also recommend surgical or laser intervention at any time. Better control of the patient's condition.
Brian left the office shocked at his condition but feeling confident about what would occur next. He now realizes that what he thought were normal accidents were actually major signs of vision loss. He can have to learn to adapt to this latest reality and hope that his remaining vision will enable him to proceed driving his forklift and his automotive.
He promised to check with everyone around him, especially his children, about his illness in order that they may very well be examined and diagnosed in time. Everyone over the age of fifty needs to be checked by an optometrist or ophthalmologist, in addition to people of any age who've a parent or relative with glaucoma.
This is the most effective solution to keep this silent killer of vision at bay.