Glaucoma awareness month

Glaucoma is the second most common cause of blindness. January is glaucoma awareness month! Help us preserve people’s vision by spreading the prevention message this month!

The term “glaucoma” refers to a group of disorders that damage the ocular nerve, leading to vision loss and blindness. Glaucoma is most commonly caused by ocular hypertension, or high pressure inside of the eye.

Typically, There Are No Early Warning Signs

What makes glaucoma so frightening is that it often becomes a sudden problem. Most people don’t notice any of the warning signs or symptoms; however, with regular eye exams we can check the pressure of your eye and monitor your risk.

Who’s Most At Risk For Glaucoma?

Though certain factors put you at higher risk, it’s important for everyone to understand the risk factors. For example, glaucoma usually affects people in their middle age—and the elderly—but it can, and does, affect people all age groups. 

African Americans are at a much higher risk and that risk spikes as early as age 40. 

South Asians and East Asians are also at greater risk. 

You’re at a higher risk over age 60 and even more so over age 80. 

Some medical conditions, like diabetes, high blood pressure, and heart disease may increase risk.
If you have a family history of glaucoma, you are a much higher risk. 

Diagnosing Glaucoma Early Can Help Preserve Sight

There’s no cure for glaucoma; however, when caught early, we can take steps to slow or halt vision loss. Often treatments as simple as specialized eye drops that reduce the pressure building up inside of your eye can make a difference.

Everyone age 40 and over should get eye exams regularly. If you have any of the high risk factors listed above, you should get an eye exam even more often! Take the time to learn more about glaucoma.

Source:

http://www.visionsource.com/blog/january-is-glaucoma-awareness-month/

Oral contraceptives double the risk of glaucoma, a leading cause of blindess

Research presented recently at the 2013 Meeting of the American Academy of Ophthalmology in New Orleans, shows that women who have taken oral contraceptives for three or more years are twice as likely to suffer from glaucoma.  Glaucoma is one of the leading causes of blindness and vision lost to glaucoma is lost permanently. Glaucoma slowly takes your vision, starting at the periphery and working its way to the center.  Many people with glaucoma don't know that they have it until it is too late. The only way to detect glaucoma early enough for effective treatment is through a regular eye exam.

This is normal vision:

This is vision with glaucoma in its advanced stages:

The study looked at 3,406 American women aged 40 years or older who completed a vision and reproductive health questionnaire and underwent eye exams. The researchers found that females who had used oral contraceptives, no matter which kind, for more then three years were 2.05 times more likely to also report that they had also been diagnosed with glaucoma.

The study means that women who have taken oral contraceptives for more than three years should have a regular eye exam to screen for the early onset of glaucoma.  Other risk factors for glaucoma include elevated pressure inside the eye, visual field deficits, family history, South Asian or African ancestry, a history of myopia and other risk factors.  See your eye doctor if you are concerned.

The study rings another note of caution for women when it comes to eye health. Women are at significantly higher risk than men for many eye diseases and must therefore ensure that they are vigilant about their eye health.  Read about women's eye health at the link below:

http://www.seeforlife.ca/2013/04/womens-eye-health-vancouver.html

Childhood Glaucoma - even kids can go blind from it

Glaucoma is most often associated with adults but childhood glaucoma also exists.  A new study from the August 2013 issue of the journal Clinical Ophthalmology found that most childhood glaucoma is found in three categories of kids.  Read more.

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Girl goes blind when she failed to get to an optometrist for an eye infection

Here is a story from the Victoria Times Columnist that reminds us to go to the optometrist whenever we have eye or vision problems.  It might save your sight.  Here is an excerpt:

Bernadine Nielsen encourages her four children to get their eyes checked every year. The 41-year old Regina-based mother and student knows all too well the perils of neglecting eye health.

 Nielsen went blind after developing eye inflammation at the age of eight. Growing up on a Cree reserve in northern Saskatchewan with her parents and six siblings, there was no easy access to medical care. Driving to see a doctor of optometry took six hours, but Nielsen to this day wishes the local nurses had encouraged her to make the trek.

 When Nielsen started experiencing symptoms of iritis, a painful condition that causes an inflammation in the iris of the eye, she wasn’t taken to see a doctor of optometry until her vision got worse, despite the fact that the condition ran in her family.

 Without medical care, Nielsen’s eyes burned, her vision became cloudy and she became extremely sensitive to sunlight. When the little girl finally made it to see a doctor of optometry, it was too late to preserve her vision.

“By then [the inflammation] had spread all over my eyes and destroyed my eye area,” Nielsen says, adding, “I suppose if I was diagnosed earlier I probably would be able to see now.”

She’s right, according to Doctors of Optometry Canada (DOC) whose experts say iritis can be treated with eye drops if caught early through an eye exam by a doctor of optometry.

Read the entire article here. 

Vision loss from glaucoma - preventable if caught early - is on the rise in Canada: Canadians are not taking easy steps to protect themselves

Research published in the June issue of the Journal of Ophthalmology shows that Canadians are not taking easy steps to protect themselves against glaucoma.  The study found that 50% of those who are newly diagnosed with the disease are already in the moderate to advanced stages of the disease.  By this time they have suffered irreversible and often devastating vision loss.

Early detection is key because if caught early glaucoma can be managed and its progress halted.  But there are virtually no symptoms in the early stages of the disease.  That is why early detection is only possible through a complete eye exam by an optometrist or ophthalmologist. 

The obvious implication of the study is that Canadians are not doing enough to protect themselves against glaucoma.  Everyone should have an annual eye exam.

An article in the Toronto Star presented the following story that puts a human face on the tragedy that can occur if one ignores the need for eye exams as well as how fortunate you can be if you see your optometrist:

Keith Henderson, 62, a retired millwright in Alvinston, Ont., is fortunate. Ten years ago his brother was diagnosed with advanced glaucoma, which prompted Henderson to see an optometrist and request extra vigilance. Extra tests — which he had to pay for — showed he had high pressure. He eventually had prophylactic laser treatment to relieve the pressure.
“I won’t lose my eyesight to glaucoma because of what has been done,” says Henderson.

Henderson’s brother, Larry, now 65, is just about completely blind now, he says. The factory worker, was 55 when diagnosed, didn’t know to get regular exams.
“He didn’t get checked because he didn’t have coverage and then it started to get severe,” Henderson says. “They’ve got him as good as they could get him, but he’s lost a terrific amount of his vision.”

Diagnoses before there is vision loss is key. For patients, who catch it early and are diligent with treatment, vision can be preserved, Buys says.

Too many are doing it too late. “In a country that boasts of universal health care, our patients are coming in with already serious and significant loss of vision,” Hutnik says.

While we have a health care systems that calls itself "universal", eye exams are not covered.  Yet, as the story above demonstrates, they are critical.  The rationale for not insuring critical health services is often founded on the principle that people must have personal responsibility for their own health.  For whatever reason - lack of knowledge, lack of resources, lack of awareness of what can go wrong with their health - too many people are not doing the right things.  I hope some of them will read this blog post and make an appointment with their optometrist. 

South Asians are at higher risk of glaucoma - January is Glaucoma Awareness Month

Look out South Asians living in North America! You have a higher risk of glaucoma than other ethnicities, according to a new American study that looked at glaucoma risk among Asian Americans, including those of Indian and Pakistani ancestry. While the study looked at Americans, the findings will likely apply to Canadians who share a similar diet and lifestyle.

The study concluded that, among Asian Americans, Japanese Americans have the highest risk (9.5%) followed by Indian and Pakistani Americans (7.7%) of open angle glaucoma, the most common variant of the disease.


If you have a high risk of glaucoma, the best thing that you can do to protect yourself is to see the eye doctor at least once a year. Glaucoma can only be detected early enough in an optometric eye examination. It does not cause pain or blurriness or other obvious symptoms. That is why doctors often call glaucoma the "silent thief of sight". The disease is so gradual that you will likely not know that you have suffered permanent vision loss, beginning with your peripheral vision. Some people with undiagnosed glaucoma are no longer legal to drive and don't know it. Read this older post for more about glaucoma.

For optometrists and ophthalmologists, this study means that they need to carefully examine their Asian patients and check both the pressure inside he eye and assess the condition of the optic nerve as well as perform visual field testing where appropriate.

January 2013 is Glaucoma Awareness Month

January is Glaucoma Awareness Month. We urge everyone to take control of their eye health and have an eye exam to help minimize the risk of developing glaucoma.  When you lose vision to glaucoma, you never get it back.

Glaucoma is the second leading cause of blindness in Canada. Even so, public awareness around glaucoma is low. For example, according to a recent survey by the American Optometric Association:

• 90% of respondents think glaucoma is preventable. Only
10% know it's not, but that it's treatable.
• 86% don't know what part of vision glaucoma affects.
• 72% think glaucoma has early warning signs.

The truth is that the only defence against glaucoma is early diagnosis and treatment. People who wait until something noticeable happens to their vision are too late. They have already suffered permanent vision loss.

Regular eye exams are the first line of defense for early detection of glaucoma. Glaucoma is often called the silent thief of sight because it often strikes without pain or other symptoms. That's why it is critical for patients to receive a dilated eye exam from their eye doctor so that eye pressure and and the nerves in the eye can be examined for signs of glaucoma.

Ethnicity affects your risk of developing glaucoma. For example, South Asians have a higher risk than Europeans of developing glaucoma.

Recent studies show that Canadians are not taking basic steps (getting eye exams) to protect themseves against glaucoma. And by the time they are diagnosed, they have already lost vision that they will never get back. It does not have to be that way if you take control of your health and get regular eye exams.

Related Articles
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Feb 27, 2012

Vision loss from glaucoma - preventable if caught early
Nov 02, 2011

South Asians are at higher risk of glaucoma
Apr 28, 2011
Health warning on eye drop - glaucoma risks
Jan 05, 2012
The myopia epidemic: why it is so dangerous- myopia and glaucoma risks
Oct 12, 2011

Only 38 years old and risking blindness - man suffers permanent vision loss after avoiding the eye doctor for years 
May 24, 2011

The best protection against glaucoma

Regular eye exams are the best protection against glaucoma

Awareness is is the key to beating glaucoma.  A recent study has shown that Canadians are not doing enough to protect themselves (by getting regular eye exams) and that glaucoma rates  are rising in Canada.  This shows just how important glaucoma awareness is. 

Glaucoma is called the silent thief of sight because by the time one realizes they have it, it is already too late to reverse vision loss.

Glaucoma is a complicated disease that damages the optic nerve, leading to progressive, irreversible vision loss. It is a leading cause of blindness.

Vision loss is permanent

When glaucoma damages your optic nerve, you begin to lose patches of vision, usually starting with your side vision (peripheral vision). Over time, glaucoma may also damage central vision. Many people do not notice a loss of side vision until they have permanently lost a great deal of vision. That is why it is so important to get annual eye exams that can diagnose glaucoma before it is too late. Those who have risk factors for glaucoma may need more frequent eye exams (talk to your eye doctor if you are unsure about how often to have an exam).  When checking for glaucoma, eye doctors usually look for damage to the optic nerve and any loss of side vision. They may also check your eye pressure because high pressure in the eye can damage the optic nerve.

Once glaucoma takes your vision, you will never get it back.  Early detection is the best way to retain your sight.

DIFFERENT TYPES OF GLAUCOMA

There are several different types of glaucoma, with the most common being open angle glaucoma. Other relatively common types of glaucoma include normal tension glaucoma, acute (angle closure) glaucoma, secondary glaucoma, and post-surgical glaucoma.

Open angle glaucoma results when fluid drains too slowly from the optic nerve area and pressure inside the eye builds up. The high pressure inside the eye damages the optic nerve such that the nerve can no longer send signals to the brain.  In the early stages of the disease, this is experienced as patches of blurred or smudged vision.

Normal tension glaucoma, also called low-tension or normal-pressure glaucoma, is characterized by optic nerve damaged even though the pressure in the eye is not very high.  The cause of this type of glaucoma is still a mystery.  People with a family history of normal-tension glaucoma are at higher risk, as are people of Japanese ancestry and people with a history of systemic heart disease such as irregular heart rhythm.

Acute (angle closure) glaucoma is characterized by a sudden rise in pressure inside the eye.  Emergency medical attention is required if this happens.  The signs associated with acute glaucoma include blurred vision, severe headaches, eye pain, nausea, vomiting or seeing rainbow-like halos around lights. Occasionally, the condition may be without symptoms. Acute glaucoma occurs in less than 10 percent of Caucasians or African-Americans, but for those of Asian and Native American descent the risks are higher.

Secondary glaucoma results from certain diseases and conditions that damage the eye's drainage system such as diabetes, leukemia, sickle-cell anemia, some forms of arthritis, cataracts, eye injuries or inflammation of the eye, the use of drugs that contain steroids and growth of unhealthy blood vessels. Ten percent of all glaucoma cases are secondary glaucoma.

Post-surgical glaucoma is a result of surgery. Specific eye surgeries, such as retinal reattachments, increase the chance of getting glaucoma. Make sure your eye doctor discusses the risks of any proposed eye surgery, including the risk of developing glaucoma.

If you click on the picture accompanying this post (or just click here) you will be directed to a handy PDF flyer that you can print or email and share with family, friends and co-workers.  Help raise awareness of glaucoma during Glaucoma Awareness Month!

The BC Doctors of Optometry Blog recently did a post on glaucoma.  Read it here.

Health warning on eye drops

This is a re-post of a glaucoma related topic I addressed last year. I'm posting it again in honor of glaucoma awareness month.  It highlights just one of the ways that glaucoma can sneak up on an unsuspecting patient.

 I've noticed something troubling lately.  People may be misusing eye drops that contain steriods (usually when prescribed by doctor who is not an eye specialist).  Steriod eye drops need to be carefully regimented and their use needs to be monitored by an eye doctor. They should never be taken "as needed". 

If not used properly, steriods can cause glaucoma - a disease that raises the pressure in the eye, damaging the optic nerve and causing permanent vision loss that starts with the peripheral vision and works its way to the centre.  I've seen this problem in my clinic and it is the last thing that a patient expects.  The only way to catch it before it's too late is to see your optometrist for an eye exam.
There are so many things that can sneak up on your health.  People need to see their doctors (not just optometrists) regularly so that issues like this can be nipped in the bud.  I bet dentists could tell similar stories.  Another point is that doctors shouldn't stray beyond their comfort zone or level and area of expertise.  When in doubt, refer the patient.

Eye drops image courtesy of marin/FreeDigitalPhotos.net. 

The myopia epidemic: why it is so dangerous.

Myopia, also called nearsightedess, is increasing in the population at an alarming rate.  According to the National Institutes of Health in 1972, the frequency of myopia was 25% in Americans aged 12 to 54. By 2004, it had increased to 41.6%. (Roan,2010).

Even worse than the increasing frequency of myopia is that for affected individuals it has a tendency to get worse over time.  Some of you may say, "Who cares? People can wear glasses."  Corrective lenses may fix a myope's blurry vision but myopia is far more dangerous than blurry vision.

The danger of myopia is that it can lead to blindness due to the adverse ocular changes associated with it.  Myopia causes abnormal stretching or elongation of the eye which can cause thinning and weakening of the retina (the thin membrane at the back of the eye that contains the cells that send visual information to the brain).   This elongation may pull on the vitreous (the gel substance that fills the eye) which in turn pulls on the retina.  This proces can cause a retinal detatchment - a  medical emergency requiring immediate surgical attention.  A detached retina can lead to blindness.

Another problem with myopia is glaucoma.  Moderate to highly myopic people are twice as likely to develop glaucoma. (Mitchell 2000).  Threfore, it is important for myopic individuals to see thier optometrist regularly to ensure that glaucoma is not developing.

Because of the dangers of myopia, scientists have been working on ways to stop myopia progression.  Orthokeratology is one solution that has been shown to be effective in a number of studies from around the world.  Orthokeratology is a treatment where the patient wears a night-time retainer lens while sleeping.  The retainer changes the shape of the cornea so that the patient experiences clear vision during the day.  In addition to being an alternative to glasses, contacts and laser surgery, orthokeratology retainers can slow or stop the progression of myopia. 

Only 38 years old and risking blindness

May is vision health month. So it is appropriate that Global News did a story on the six o'clock news on Victoria Day highlighting the dangers of getting automated sight tests from opticians rather than a comprehensive eye exam from a doctor of optometry. You are risking blindness.



Eye exams by a doctor of optometry assess the health of your eye and its component parts like the optic nerve. This is only way to diagnose glaucoma and other diseases early enough to prevent permanent vision loss.

Jason Inman was getting automated sight tests from an optician for years. He thought he was too young to need an eye exam from an eye doctor. He was wrong and and tragic consequence was permanent vision loss.

In his interview he talks about having a permanent smudge in his vision. This will likely never go away. For his eyes to get this bad, he must have suffered severe and permanent vision loss. Going by what he said in his interview, he is probably barely legal to drive, if is he is legal at all.

The good news is that now that he has gone to his optometrist, his disease is diagnosed and can be treated and the progression can be halted. The tragedy, of course, is that if he just visited his optometrist regularly he would not have suffered permanent vision loss. The thing that makes glaucoma so dangerous is that the person with the disease will not know that he has it until serious vision loss has already occurred.

It is true that this blog emphasizes glaucoma and eye exams but everyone out there needs to take their health seriously and be proactive and you need to see the eye doctor regularly. The consequences are just not worth it.

Another point is that BC's eye care regulations are obviously not rational if they allow automated sight testing because people are being lulled into a false sense of security regarding their health. Like Jason Inman said in his interview, he really did not think about whether his eye health was being looked after. That is understandable. In this busy world we often don't have time to think about our health. That is why we have doctors to look after us. I think that many people are just like Jason Inman. But I hope that they don't suffer the same consequences.

"Get your eye glasses for free - and save your sight in the process"

Free Eye Glasses to See for Life

I'm doing what I call a "See for Life" campaign by giving away free prescription glasses to my patients.   In case you are wondering, that includes the frame, single vision lenses, scratch resistant coating and 100% UV protection.  The idea is to motivate people to come in for their annual eye health exam. 

What prompted me to do this?  I was seeing lots of patients who have gone years without an eye exam.   I've had the sad responsibility to tell some of these people that they have glaucoma.  Not only that, but the disease has already caused permanent vision loss in some of these people.  One unlucky man had lost enough peripheral vision that he was no longer legal to drive.  If there is one happy note in the latter story, this unfortunate fellow didn't earn his living driving a vehicle.  If there are any truckers or cab drivers or pilots out there, do not take your eye health for granted!  Being blind (pun intended) to the risks could have a huge impact on your life.  The tragedy is that only if they would have come in for an exam, we would have caught glaucoma early and stopped its progression.

No one needs to loose their vision because of glaucoma but it happens if you are not proactive.  See your eye doctor once a year to make sure that you are free of the disease and that you are not at risk. 

How do I know if I have glaucoma?

The only way to know is to see your eye doctor.  The disease slowly and imperceptibly robs you of your vision.  The poor man who lost his license suffered permanent vision loss but he never knew it was happening. It sneaks up on you quietly.  Don't let it get you!

So here is what I'm doing to motivate people to take their health seriously:  if you are between the ages of 19 and 64 you can get your glasses for free when you have your eyes examined.  You can get more information from my website: www.freeglasses.ca.

Health warning on eye drops

I've noticed something troubling lately.  People may be misusing eye drops that contain steroids (usually when prescribed by doctor who is not an eye specialist).  Steroid eye drops need to be carefully regimented and their use needs to be monitored by an eye doctor. They should never be taken "as needed". 

If not used properly, steroids can cause glaucoma - a disease that raises the pressure in the eye, damaging the optic nerve and causing permanent vision loss that starts with the peripheral vision and works its way to the center   I've seen this problem in my clinic and it is the last thing that a patient expects.  The only way to catch it before it's too late is to see your optometrist for an eye exam.

There are so many things that can sneak up on your health.  People need to see their doctors (not just optometrists) regularly so that issues like this can be nipped in the bud.  I bet dentists could tell similar stories.  Another point is that doctors shouldn't stray beyond their comfort zone or level and area of expertise.  When in doubt, refer the patient.


Eye drops image courtesy of marin / FreeDigitalPhotos.net.