During Glaucoma Awareness Month in January, the National Eye Health Education Program (NEHEP) Partnership, coordinated by the National Eye Institute (NEI), is highlighting the medical advances for glaucoma that have been developed during the past five years.
"These therapies effectively treat glaucoma while at the same time greatly reducing side effects," said Jack A. McLaughlin, Ph.D, acting director of the NEI, one of the Federal government's National Institutes of Health.
Glaucoma, a leading cause of irreversible vision loss in the United States, is a disease that affects three million Americans, half of whom do not know they have it because of its lack of early symptoms. Advances in glaucoma treatment are only beneficial when the disease is detected early. By the time people realize they are losing vision, the vision they have already lost is gone forever. Those in higher risk groups should get a dilated eye exam in which drops are placed in the eye to dilate the pupils at least every two years. A dilated eye exam allows the eye care professional to obtain a better view of the eye's optic nerve to look for early signs of glaucoma. Higher risk groups include anyone over the age of 60; African Americans over the age of 40; and people who have a family history of glaucoma.
Two new glaucoma drugs latanoprost and dorzolamide based on NEI-supported research, "reduce unpleasant side effects, such as dry eyes and increased risk of retinal detachment," Dr. McLaughlin said. "The side effects from the older glaucoma treatments were major reasons why some glaucoma patients did not take their medications. The new therapies help preserve remaining vision and mark a significant step in improving the quality of life for people with glaucoma."
Glaucoma occurs when nourishing fluid that normally flows in and out of the eye drains too slowly. As the fluid builds up, the pressure inside the eye progressively increases. This leads to optic nerve damage and reduced peripheral (side) vision. As the disease worsens, the field of vision gradually narrows and blindness may result. However, if glaucoma is detected and treated early in its progression, it can usually be slowed and serious vision loss can be delayed.
Dr. McLaughlin also noted that NEI-supported research has shown that laser surgery is a safe and effective alternative to eye drops as a treatment for newly-diagnosed glaucoma. Laser surgery for glaucoma involves using a high energy beam of light to make tiny, evenly-spaced burns that open up the drainage area inside the eye, allowing for better outflow of the fluid. This procedure, often done in the doctor's office, requires only local anesthesia.
One of the more significant recent research findings was that Black and White patients with advanced glaucoma respond differently to two surgical treatments for the disease. Scientists found that Black patients with advanced glaucoma benefit more from a regimen that begins with laser surgery, and Whites patients benefit more from one that begins with an operation called a trabeculectomy. With this procedure, a small opening is made in the front chamber of the eye, providing a new drainage pathway for the fluid inside the eye. A trabeculectomy is done in an operating room and requires local or general anesthesia.
"This was the first evidence that unique patient characteristics could influence our therapeutic choices for glaucoma," said Eve Higginbotham, MD, chairperson of the NEHEP Planning Committee and chairperson of the Department of Ophthalmology at the University of Maryland. "Doctors now have better information to recommend treatment programs, depending on the patient's race, and give people with advanced glaucoma a better chance to preserve and prolong their vision." Glaucoma is three to four times as common in Blacks as in Whites, and blindness from glaucoma is six times more common in Blacks than in Whites.
Glaucoma Awareness Month is sponsored by the NEHEP Partnership, which represents public and private organizations dedicated to educating the public about the importance of preventive eye care.