Save Your Sight from Glaucoma: Sources

TITLE: Save Your Sight from Glaucoma

SUBTITLE: Prevent this devastating disease from stealing your vision

SECTION 1 HEADING: Glaucoma is a leading cause of irreversible blindness in the United States and in the world.

• “Don’t Lose Sight of Glaucoma – Information for People at Risk.” National Eye Institute (NEI), 2005 http://www.pueblo.gsa.gov/cic_text/health/glaucoma/glaucoma.htm VISION 2020 Global Initiative for the Elimination of Avoidable Blindness: Action plan 2006-2011. World Health Organization, 2007

SECTION 1 BODY: More than 3 million Americans aged 40 and older have glaucoma.

• David S. Friedman, M.D., M.P.H., Assistant Professor of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, “2012 Fifth Edition of Vision Problems in the U.S.,” http://www.visionproblemsus.org/introduction/acknowledgments.html SECTION 1 BODY: It is estimated that the number will double to 6 million people by the year 2050. Source NEI website Eye Health Data and Statistics under “Projections for Glaucoma (2010-2030-2050)”, as of October 11, 2013

SECTION 1 BODY: Glaucoma costs the U.S. economy at least $2.86 billion every year in medical costs and productivity losses.

• “The Economic Burden of Major Adult Visual Disorders in the United States,” David B. Rein, PhD; Ping Zhang, PhD; Kathleen E. Wirth, BA; Paul P. Lee, MD, JD; Thomas J. Hoerger, PhD; Nancy McCall, ScD; Ronald Klein, MD, MPH; James M. Tielsch, PhD; Sandeep Vijan, MD, MS; Jinan Saaddine, MD, MPH, Arch Ophthalmol. 2006;124:1754-1760

SECTION 2 HEADING: What is glaucoma?

SECTION 2 BODY: Glaucoma is a group of eye disorders that eventually lead to optic nerve damage, which can then lead to vision loss or complete blindness.

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SECTION 2 BODY: Roughly 70-90% of people with glaucoma have its most common form, open-angle glaucoma. Other types include angle-closure, normal-tension, congenital, juvenile, and secondary glaucoma.

SECTION 2 BODY: Open-angle glaucoma, the most predominant form, has no symptoms until sufferers begin to lose their peripheral vision.

• NOTE: multiple sources
  • Dr. Quigley = 74% http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856963/ “There will be 60.5 million people with OAG and ACG in 2010, increasing to 79.6 million by 2020, and of these, 74% will have OAG.”
  • Cleveland Clinic = 90% http://my.clevelandclinic.org/disorders/glaucoma/hic_glaucoma.aspx “Open-angle glaucoma is the most common type, found in approximately 90 percent of glaucoma patients in the United States.

SECTION 2 BODY: Acute angle-closure glaucoma is a medical emergency and must be treated immediately or blindness could result in one or two days. Symptoms may include severe pain, nausea, vomiting, blurred vision and seeing a rainbow halo around lights. Chronic angle-closure glaucoma progresses more slowly and can damage the eye without symptoms.

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SECTION 2 BODY: Normal-tension glaucoma often has no symptoms until sufferers begin to lose their peripheral vision.

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SECTION 2 BODY: There is no cure for glaucoma. Vision loss caused by glaucoma is permanent.

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SECTION 3 HEADING: Certain groups of people are at a higher risk for glaucoma.

SECTION 3 BODY: In the United States, glaucoma is approximately 3-4 times more common among Blacks and Hispanics than Whites. Between the ages of 45 and 64, glaucoma is 15 times more likely to cause blindness in Blacks than in Whites.

Multiple sources:

• “Blindness and Visual Impairment-A Public Health Issue for the Future as Well as Today (editorial),” Archives of Ophthalmology 2004; 122:451-452
• “Prevalence of Open-Angle Glaucoma Among Adults in the United States,” Archives of Ophthalmology 2004; 122:532-538
• “Prevalence of Cataract and Pseudophakia/Aphakia Among Adults in the United States,” Archives of Ophthalmology 2004; 122:487-494
• “Prevalence of Diabetic Retinopathy Among Adults in the United States,” Archives of Ophthalmology 2004; 122:552-563
• “The Prevalence of Diabetic Retinopathy Among Adult Type I Diabetic Persons in the United States,” Archives of Ophthalmology 2004; 122:546-551
• “Prevalence of Age-Related Macular Degeneration in the United States,” Archives of Ophthalmology 2004; 122:564-572
• “The Prevalence of Refractive Errors Among Adults in the United States, Western Europe, and Australia,” Archives of Ophthalmology 2004; 122:495-505
• “Causes and Prevalence of Visual Impairment Among Adults in the United States,” Archives of Ophthalmology 2004; 122:477-485

SECTION 3 BODY: Asian Americans should be aware of the increased risk for angle-closure glaucoma and normal-tension glaucoma relative to individuals of other ethnic backgrounds.

• "Differences in rates of glaucoma among Asian Americans and other racial groups, and among various Asian ethnic groups." Stein JD, Kim DS, Niziol LM, Talwar N, Nan B, Musch DC, Richards JE., Ophthalmology. 2011 Jun;118(6):1031-7. Epub 2011 Feb 18., PMID: 21310489 http://www.ncbi.nlm.nih.gov/pubmed/21310489

SECTION 3 BODY: Strong risk factors for open-angle glaucoma include high eye pressure, a family history of glaucoma, being older than age 40 for Black Americans, being older than age 60 for the general population, a thin cornea, and a suspicious optic nerve appearance.

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Potential risk factors are very severe nearsightedness, diabetes, eye surgery or injury, high blood pressure, and use of corticosteroids.

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SECTION 3 BODY: Risk factors for angle-closure glaucoma include older age, family history, farsightedness, and eye injury or surgery.

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SECTION 3 BODY: Risk factors for normal-tension glaucoma include cardiovascular disease, family history, and low eye pressure.

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SECTION 4 HEADING: Annual comprehensive dilated eye exams are the best way to protect your vision against glaucoma. Testing is painless and non-invasive.

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SECTION 4 BODY: Less than half of all adult Americans have comprehensive dilated eye exams at least every two years. Only half of people living with glaucoma are likely aware that they have it.

• Quigley, H. A., Broman, A. T., “The number of people with glaucoma worldwide in 2010 and 2020,” British Journal of Ophthalmology (2006); 90:262–267. doi: 10.1136/bjo.2005.081224

SECTION 4 BODY: A dilated pupil eye exam is the most effective way to detect glaucoma. Special drops temporarily enlarge the pupil so the doctor can better see inside the eye.

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SECTION 4 BODY: Other tests include:

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• Visual field testing, which measures straight-ahead and side vision using lights of varying brightness.
• Tonometry testing, which measures eye pressure using a puff of air or an instrument that briefly touches the numbed eye.
• Visual acuity testing, which measures how well patients can read a chart from various distances.
• Pachymetry testing, which measure corneal thickness using an ultrasonic wave instrument that briefly touches the numbed eye.
• Gonioscopy testing, which allows the doctor to view the angle at which the iris meets the cornea using a special contact lens placed on the numbed eye.
• Optic nerve imaging, which allows the doctor to monitor any optic nerve changes over time using special computer imaging machines.

SECTION 5 HEADING: Early diagnosis and treatment are key to saving your sight from glaucoma.

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SECTION 5 BODY: Prescription eye drops and occasionally pills

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SECTION 5 BODY: Laser treatment

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SECTION 5 BODY: Surgery

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Last Review: 11/22/13