We all want to age gracefully, and part of that means staying as healthy and independent as we can into our “wisdom years.” A survey of Americans found that after cancer and heart disease, blindness ranks third as a major health fear of aging.

Yet, in the same survey (Prevent Blindness America, 2002), only 7 in 10 Americans had ever heard of the leading cause of blindness—glaucoma. It is estimated that 3 to 4 million Americans have glaucoma, but only about half know that they have it.

That’s because it easily can go undetected. In fact, its most common form—open-angle glaucoma—has been called “the sneak thief of sight” because it often has no noticeable symptoms until there has been significant, permanent vision loss.

What is glaucoma?

Glaucoma is a group of eye conditions that cause damage to the optic nerve, a part of the eye that is vital to vision. This damage often is caused by abnormally high pressure (ocular hypertension) in the eye. 

With the most common form, open-angle glaucoma, the eye’s drainage canals become clogged over time, causing increasing pressure in the eye that pushes and damages the optic nerve. There is no pain associated with this pressure, and vision loss usually begins as patchy blind spots in your side vision, also known as peripheral vision. People usually don’t notice blind spots in their peripheral vision because we unconsciously turn our heads to compensate for it, and with open-angle glaucoma, the loss of side vision happens gradually. In advanced stages, tunnel vision and eventual blindness result.

In a rare form called narrow angle (or acute angle-closure) glaucoma, ocular hypertension can happen suddenly or gradually. Symptoms are very noticeable and damage occurs quickly.

Glaucoma cannot be cured, but it can be treated to minimize damage—meaning, early detection is your best defense against vision loss.

Screenings for early signs of open angle glaucoma

The most common form of glaucoma—open angle glaucoma— has no obvious early warning signs; it can only be detected through an exam by an ophthalmologist. That is why it is crucial to get regular eye check-ups.  The Glaucoma Research Foundation recommends that people from age 55 to 64 should get a complete eye exam by an ophthalmologist every one to two years. After age 65, schedule your eye exam every six to twelve months.

Your ophthalmologist will likely perform two routine eye tests to screen for glaucoma:

Tonometry measures the pressure within your eye. During tonometry, eye drops are used to numb the eye and a small amount of pressure is applied to the eye by a tiny device or by a warm puff of air. 

Ophthalmoscopy allows your eye doctor to examine your optic nerve for glaucoma damage. During ophthalmoscopy, a small device with a light on the end is used to light and magnify the optic nerve, giving your doctor a clear view of your optic nerve.

Depending on the results of these two exams, your doctor may recommend additional testing.

Know the signs and symptoms of narrow angle glaucoma

There are very noticeable signs of the rare form of narrow angle glaucoma. If you experience any of the following symptoms, especially more than one, get to an emergency room or eye doctor right away.

  • Severe headache
  • Eye pain
  • Blurred vision or sudden vision loss
  • Nausea or vomiting
  • Halos or rainbows around lights
  • Eye redness

Who is at risk for glaucoma?

Unfortunately, everyone is at risk for glaucoma. You may be considered high-risk if you fall into any of these categories:

  • Over 60 years old: People over 60 are 6 times more likely to get glaucoma.
  • Family members with glaucoma: The most common form of glaucoma (open-angle) is hereditary. Family history increases your risk four to nine times.
  • African American: African Americans are six to eight times more likely to get glaucoma than Caucasians. After cataracts, glaucoma is the leading cause of blindness for people of African descent.
  • Asian: People of Asian descent seem to be at higher risk for glaucoma, especially the rare form (narrow angle).
  • Hispanic: People of Hispanic descent seem to be at higher risk for glaucoma, especially after 60.
  • Steroid use: Using steroids, especially high-dose asthma inhalers, may increase your risk for ocular hypertension and glaucoma.
  • Eye injury: Blunt trauma (bruising) or a piercing of the eye may cause damage to the eye’s drainage system, leading to glaucoma.
  • Drastic nearsightedness (high myopia)
  • Diabetes
  • High blood pressure (hypertension)
  • Thin cornea

People considered “high-risk” for glaucoma should get complete eye exams on a regular schedule prescribed by their doctors.

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