Learn the risk factors

Approximately 2.7 million Americans have the potentially blinding eye disease glaucoma, but only half are aware of it. Meanwhile, glaucoma incidence is on the rise. Researchers predict that glaucoma will affect as many as 6.3 million Americas by 2050. 

The California Academy of Eye Physicians and Surgeons (CAEPS) and the American Academy of Ophthalmology (AAO) are sharing a list of disease risk factors in recognition of January as "National Glaucoma Awareness Month."

“It is imperative that people understand the precursors to this debilitating disease,” said Amin Ashrafzadeh, MD, CAEPS President. “If you are at risk, then getting an exam from an ophthalmologist as soon as possible can help protect you from vision loss.”

Glaucoma is a group of eye diseases that damage the optic nerve, which links the eyes to the brain. It is most commonly associated with elevated pressure inside the eye, known as intraocular pressure, or IOP. Without treatment, glaucoma can cause irreversible vision loss in a person’s side vision, then in his or her central vision. With early diagnosis and treatment, sight can be preserved. However, glaucoma has no noticeable symptoms in its early stages, so it is imperative that people know the risk factors.

Certain factors can increase an individual’s risk of developing glaucoma, including:

• Family History: Individuals with a parent or sibling with glaucoma have a nine times higher risk of developing the disease, according to one study.

• Older Age: As people age, their risk for glaucoma increases. Because this is the case for several eye diseases, both Academies recommend that adults start getting regular comprehensive eye exams at age 40. This is the age when early signs of eye disease and changes in vision may first occur, even if you have seemingly perfect vision. So, it is important to get a comprehensive eye exam from an ophthalmologist, a physician specializing in medical and surgical eye care.

• African, Hispanic or Asian Heritage: People of African and Hispanic heritage are three times more likely to have the most common form of glaucoma than Caucasians. Glaucoma-related blindness is at least six times more prevalent in African Americans than in Caucasian Americans. Additionally, people of Asian heritage are at an increased risk of a sudden and acute form of glaucoma known as angle-closure glaucoma.

• Nearsightedness: People who are nearsighted are more likely to have glaucoma. One study even found that the more severe the nearsightedness, the higher the risk of glaucoma.

• Type 2 Diabetes: Having type 2 diabetes increases the risk of glaucoma. The longer a person has lived with diabetes, the greater their risk for glaucoma becomes.

Additionally, when the cornea – the clear, round dome on the front of the eye that covers the iris and pupil – is abnormally thin, IOP readings may be falsely low. This puts patients at increased risk for undiagnosed glaucoma. This is common among those who have had refractive surgery, such as LASIK or photorefractive keratectomy. Another risk factor associated with glaucoma is a history of eye trauma.

“Many of my patients are surprised to learn that one or more of these factors put them at an increased risk,” said CAEPS member Andrew Iwach, M.D., a clinical spokesperson for the AAO and a glaucoma specialist. “Being aware of your personal risk of glaucoma is the first step to saving your sight.”

Glaucoma treatment ranges from medicated eye drops to a variety of surgeries that can help reduce high IOP. This may involve procedures that make small changes in the eye to help fluid drain more easily. In some cases, small devices known as shunts or stents are inserted in the eye to increase the flow of the eye’s fluid out of the eye.

People age 65 or older and concerned about their eye disease risk may be eligible for a medical eye exam at no out-of-pocket cost through EyeCare America™, a program of the Foundation of the AAO. In addition, those who are at an increased risk for glaucoma may also qualify for a glaucoma exam through EyeCare America. This public service program matches volunteer ophthalmologists with eligible patients in need across the United States. To see if you, your friends or family members are eligible, visit www.eyecareamerica.org.

To learn more about glaucoma, its risk factors and its treatment, visit www.geteyesmart.org.

According to a national survey released by the American Academy of Ophthalmology (AAO), nearly two out of three American adults report having eye or vision problems. A significant percentage of them, however, fail to seek medical attention in the form of regular, sight-saving eye exams. In observance of Healthy Aging Month in September, The California Academy of Eye Physicians and Surgeons joins the AAO in emphasizing the importance of having regular eye exams to maintain healthy eyes and vision.

Some of the more common age-related eye diseases include age-related macular degeneration, cataract, diabetic retinopathy and glaucoma. Early detection and treatment of these conditions can help to save sight before vision loss occurs. Ophthalmologists – the physicians that specialize in medical and surgical eye care – recommend a dilated comprehensive eye exam as the best way to prevent these conditions from becoming debilitating.

U.S. Adults Do Not Get Eye Exams as Often as Recommended
The survey results emphasize a need for more education about the importance of medical eye exams. Findings showed that 64 percent of adults had at least one or more of the following issues with their eyes or vision:

• difficulty seeing at night;
• blurry vision;
• reading up close;
• flashes of light;
• red, watery eyes; and,
• double vision.

Despite experiencing some level of impairment, only 13 percent admitted they had been seen by an ophthalmologist.

How Often Do Adults Need Eye Exams?
Both Academies recommend that a healthy adult get a baseline eye exam at age 40, even if they have no history of eye problems or eye disease. Those who have chronic conditions, such as diabetes or high blood pressure, may require more frequent exams.

"Sight is precious, and catching problems early can make a big difference in maintaining vision for the long term, says Rahul N. Khurana, MD, a retina specialist and CAEPS President.

Those over age 65 who may be concerned about cost or lack of health insurance, the AAO’s EyeCare America program offers eligible seniors a comprehensive eye exam and up to one year of treatment at no out-of-pocket cost.

To learn more ways to keep your eyes healthy, visit the AAO's  EyeSmart^® website.

One in four Americans age 65 or older has diabetes, putting them at increased risk for vision loss and blindness. Fortunately, diabetes-related vision loss is largely preventable with regular care. Yet studies have found a majority of Medicare beneficiaries with diabetes do not get the necessary eye exams despite the fact that the exams could be covered under their existing insurance.