I don't know a better way to begin the New Year than to discuss a disease that is a leading cause of blindness in African American and Hispanic populations. Appropriately, January is designated, National Glaucoma Awareness Month, and I don't want anyone to miss the opportunity to learn about glaucoma and perhaps save their sight.
Many people don't know that after cataracts, glaucoma is the leading cause of blindness in African Americans and Hispanics. This cause of blindness is not reversible once it happens. What is particularly scary is that about half of people with glaucoma don't even know that they have it because there are no symptoms. As you read this, you could be losing your sight and not realize it because the loss of sight often occurs very slowly.
Here are a few facts about glaucoma. There are two main types of glaucoma: open-angle glaucoma and angle-closure glaucoma. In these conditions, the fluid that naturally surrounds the eye (the aqueous humor) is unable to drain properly. You might think of it as a clogged drain.
As the fluid builds up, so does the pressure in the eye. The increased pressure causes damage to a very important nerve in the eye, called the optic nerve. It is the optic nerve that sends images or pictures from the eye to the brain. Damage to the optic nerve means that the images or pictures don't get to your brain so you can't see them. That is how optic nerve damage leads to blindness.
The website www.glaucoma.org discusses and lists the following groups as being at increased risk for glaucoma:
• Glaucoma is 6 to 8 times more common in African Americans than in Caucasians.
• People over 60 years of age are 6 times more likely to get glaucoma than younger people. However, this does not mean that younger people don't develop glaucoma. They do.
• A family history of glaucoma increases your risk of glaucoma 4 to 9 times. If you have family members with primary open-angle glaucoma, which is the most common type of glaucoma, and which is hereditary, you are at a much higher risk than the rest of the population.
• The risk for glaucoma in Hispanic populations is greater than for white populations, and that risk increases among Hispanics over age 60.
• Some studies have suggested that adults who use a steroid inhaler to control asthma and require high doses (many puffs) were at increased risk (according to a 1997 study from the Journal of American Medical Association).
Why am I particularly concerned about glaucoma in the African American population?
Unfortunately, glaucoma attacks the eyes earlier and progresses faster in African Americans. Glaucoma has been reported to occur about 10 years earlier in African Americans than in other ethnic populations.
Additionally, African Americans are at an even greater risk of developing glaucoma if they have:
• Extreme nearsightedness (you can't see things that are far away)
• Prolonged steroid use
• Or are over age 40
Although we don't know why African Americans have a higher rate of glaucoma and subsequent blindness, we do know that African Americans are genetically more at risk for glaucoma.
Fortunately, there are several treatments available for glaucoma. They include eye drops, laser treatments and surgery. Your ophthalmologist will determine the best treatment or combination of treatments for your particular type and extent of disease. The overall goal is to reduce the eye pressure to allow the fluid in the eye to drain properly and to prevent further eye damage and loss of sight.
The American Academy of Ophthalmology advises the pubic that the best defense against developing glaucoma-related blindness is by having routine, comprehensive eye exams (www.aao.org). They recommend a baseline examination at least by age 40, although, www.glaucoma.org, recommends that African Americans get a thorough check for glaucoma every one to two years after age 35.
You can find out if you are eligible for a free glaucoma screening by contacting the following programs:
EyeCare America -- Glaucoma EyeCare Program (800) 391-EYES (3937) After screening for glaucoma risk factors, those at moderate to high risk are referred to a participating ophthalmologist. The glaucoma exam is offered at no cost to uninsured at-risk individuals.
EyeCare America -- Seniors Eyecare Program (800) 222-EYES (3937) -- Provides free and low-cost eye exams for US citizens 65 and older who have not had access to an ophthalmologist in the past three years, and do not have eye care insurance.
Lions Club International -- (630) 571-5466 (national office) -- Provides financial assistance to individuals for eye care through local clubs, although services vary from club to club. Check your telephone book for the telephone number and address of your local club.
Medicare -- (800) 772-1213 -- Provides an annual dilated eye exam for Medicare beneficiaries over 65 at high risk for glaucoma. Those eligible for this service are people with diabetes, family history of glaucoma, or African-Americans over 50.
[Resources used for this article include the following: www.preventblindness.org, www.glaucoma.org, www.aao.org]
Susan Taylor, MD
Society Hill Dermatology
Medical correspondent and anchor, Health Quest: Making a Difference in Your Life, WURD 900AM, Philadelphia, PA