Pubdate: Thu, 23 Jan 2003
Source: Sun Herald (MS)
Copyright: 2003, The Sun Herald
Contact:  http://www.sunherald.com
Details: http://www.mapinc.org/media/432
Author: Jean Prescott

LOOKING OUT FOR YOUR EYES

Early Detection Of Glaucoma Key To Treatment Of Irreversible Disease

"Make the diagnosis early," says Dr. Barry Marshall, who operates Marshall 
Eye Clinic in Gulfport. "The earlier you catch glaucoma the better, because 
if the (optic) nerve is damaged, it becomes much more vulnerable."

Glaucoma, for the uninitiated, is a sight-threatening disease for which 
doctors routinely check during an eye exam, but even people with apparently 
perfect vision, those with no other reason to have their eyes examined, may 
be developing glaucoma and not know it.

January is National Glaucoma Awareness Month, so it's a perfect time to 
study the risk factors for this treatable but irreversible eye disease and 
decide if an exam is called for.

According to Marshall, there is no way to prevent glaucoma.

"It's hereditary," he says, "family history being only one risk factor. 
Others are age (glaucoma is rare in people under age 40), nearsightedness, 
diabetes, a prior injury (being beaned by a baseball may lead to glaucoma 
down the road) and the use of certain steroids, usually in the form of eye 
drops."

The presence of one or more of these risk factors does not guarantee the 
development of glaucoma, but they are red flags. The presence of more than 
one indicates the need to be checked for early signs.

"It's a painless pressure test," Marshall explains, "and there are a couple 
of different ways it can be done, but it's part of a routine eye exam that 
also includes dilating the eyes to look inside at the optic nerve."

Doctors have discovered that as many as 20 percent of people with 
developing glaucoma can have an intraocular (or inside the eye) pressure 
that is normal. A good look at the optic nerve can reveal as much as the 
pressure test.

"You have to assess the healthiness of the optic nerve," says Marshall, and 
"we will do a visual field test when we actually think we have glaucoma, if 
the nerve looks suspicious and/or there is elevated pressure."

Let's say the diagnosis is positive, there is evidence of glaucoma. Will 
you lose your sight?

Marshall repeats, "We can't get back lost vision. All we can do is protect 
what's left, so the sooner we know, the better."

Treatment usually begins with topical drops that lower the pressure in the 
eye and protect the optic nerve.

"It's where we start. The higher the pressure, the greater the risk of 
glaucoma," Marshall says, "and pressure is a variable we can control. There 
also are laser treatments, surgical treatments that can help, but it all 
depends on if it's caught early enough to be controlled and managed."

Once the loss of vision - even peripheral vision, which deteriorates first 
- - becomes noticeable, the disease has moved past its early stages, and 
treatment becomes more intensive.

According to Marshall, a person should consult his or her doctor about 
living with glaucoma, and decisions about such things as driving or wearing 
contact lenses should be made with a doctor's recommendation.

Finally, in the matter of marijuana as a treatment for glaucoma, Marshall 
had this to say: "It has been shown to lower pressure in the eye, but it 
doesn't do it better than legal medications that don't have an abuse 
potential." He adds that there are drugs as effective or more effective 
than marijuana.

"People have to be able to function in their daily lives," he says.

Many resources on the Web can help answer questions about glaucoma. Some 
include diagrams of the eye, which may help in understanding the disease. 
Check out The Glaucoma Foundation at www.glaucoma-foundation.org. The 
American Optometric Association also has information on glaucoma on its Web 
site at www.aoa.org/conditions/glaucoma. You also can contact your eye care 
provider for more information on glaucoma.

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Some symptoms

The most common type of glaucoma develops gradually and painlessly, without 
early symptoms. In later stages, symptoms may occur, including the following:

Loss of peripheral vision.

Difficulty focusing on close work.

Seeing colored rings or halos around lights.

Headaches and eye pain.

Difficulty adjusting eyes to the dark.Online info

The Glaucoma Foundation at www.glaucoma-foundation.org

The American Optometric Association at

www.aoa.org/conditions/glaucoma
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MAP posted-by: Larry Stevens