September 19, 2023 – A silent disease is increasing amongst older people around the globe: thousands and thousands of them unknowingly suffer from glaucoma – a watch disease that may result in irreversible blindness but by which obvious symptoms only appear within the late stages of the disease, ophthalmologists warn.
It is predicted By 2050, the variety of glaucoma patients will increase by greater than 200%, highlighting the urgent need for increased education, early detection and advanced treatment strategies.
“That’s a lot of people with a blinding disease who don’t know they have it,” said Joel S. Schuman, MD, professor of ophthalmology and co-director of the glaucoma service at Wills Eye Hospital in Philadelphia. “As the disease progresses, people may notice that they're tripping on the curb or running into things they didn't see. It isn't until the disease may be very advanced that folks realize something is fallacious.”
glaucoma is the second leading cause of blindness worldwide, affecting three million people in the United States according to the CDC, and yet half of those affected are unaware of the disease.
Recent Research at the University of Gothenburg in Sweden highlights the insidious nature of glaucoma: 5% of 560 70-year-olds were affected and half of them were unaware of their disease before participating in the study.
“Living with glaucoma, especially without realising it, could be very isolating,” said Lena Havstam Johansson, a doctoral student at the University of Gothenburg and a specialist nurse at Sahlgrenska University Hospital who conducted the study. “It can lead people to remain at home to avoid the symptoms.”
Once symptoms appear, some people notice patchy blind spots in their peripheral vision and, in later stages, in their central vision.
Although many people assume they become more clumsy as they age, Schuman said, they often have a condition that can be slowed with proper treatment.
Glaucoma occurs when pressure in the eye increases and the optic nerve, which transmits information from the eye to the brain, becomes damaged. If left untreated, it can lead to partial loss of vision or total blindness. It often develops slowly in the early stages and without any noticeable symptoms, which is why it is nicknamed “the silent thief of sight.”
Although there are different types of the disease, about nine out of 10 people in the United States have primary open-angle glaucoma (POAG).
The disease most commonly occurs in people over 60 years of age, in people with a family history of glaucoma and in people with diabetes. Black people are disproportionately affected, six times Caucasian individuals are more more likely to experience advanced vision loss from the disease.
More than 120,000 people within the USA are Blindness due to glaucomawhich accounts for 9 to 12% of all blindness cases.
Treatment options for glaucoma range from eye drops to laser treatments to surgery. All of these treatments aim to reduce eye pressure. Some doctors also recommend oral medications in addition to eye drops.
“We have many treatment options and so they work pretty much,” Schuman said. “But step one is for the person to know they've glaucoma, and the second step is for the person to get treatment.”
Rarer types of glaucoma These include normal-tension glaucoma, which is more common in people of Japanese descent, and congenital glaucoma, which is present from birth and affects about one in 10,000 babies born in the United States.
The best way to ensure early detection and treatment is to have regular eye exams — every two to four years for adults under 55 and annually thereafter, says Annie Wu, MD, clinical assistant professor of ophthalmology at the University of Michigan's Kellogg Eye Center.
The fact that the symptoms of glaucoma develop slowly and many Americans do not have access to eye doctors makes the disease even more dangerous.
The University of Pennsylvania is one of those trying to change that. The University of Philadelphia offers free glaucoma screening programs for black residents. According to the university, black Americans are five to six times more likely to develop glaucoma.
There are a number of organizations that also provide access to free glaucoma screenings.
Glaucoma test can be done during a regular eye exam and may involve one test or a combination of tests that are relatively quick and painless. These include dilating the pupil with eye drops to examine the optic nerve, as well as measuring the thickness of the cornea to find out your risk of the disease, which is higher when the cornea is thin.
“It's essential not to attend until symptoms appear – if glaucoma gets so bad that you just notice it in your central vision, which means you've lost virtually your entire peripheral vision,” Wu said. “Definitely see a watch doctor, regardless of what your loved ones history is.”