Senior living: Glaucoma and how to spot the signs of vision impairment

By Dr. Jeffrey S. Luther, 

Contributing writer 

More than 3 million Americans have glaucoma, and man y of them are seniors older than 65. Approximately 75% of people who are legally blind because of glaucoma are seniors, in fact.

And it is believed that half of those with glaucoma have not yet been diagnosed.

Jeffrey S Luther, M.D., Family Medicine, MemorialCare Long Beach Medical Center. (Photo courtesy of MemorialCare)

Glaucoma is the term used when the optic nerve is damaged from a build up of pressure in your eye. The increased pressure is caused by fluid that naturally flows through the eye not being able to escape at its previous rate. If left untreated, glaucoma can cause irreversible damage to the optic nerve, causing worsening vision and eventual blindness. Not every person over the age of 65 with increased eye pressure will develop glaucoma.

Some people can tolerate higher eye pressure better than others.

Often, glaucoma is mistaken for another common eye condition called cataracts. Cataracts, like glaucoma, causes a slow, gradual loss of vision over time. But a cataract is created when the protein that makes up the lens of an eye begins to clump together, gradually causing the clear lens that helps focus light in the eye to become cloudy.

Signs of cataracts or glaucoma

Cataracts and glaucoma share a few similar symptoms in the early stages that seniors should be aware of, including cloudy or blurry vision, and seeing rainbow-colored rings or halos around light. Those who experience these symptoms should talk to a doctor to see if additional steps are necessary.

Glaucoma, however, typically starts with a loss of peripheral vision, or side vision. This looks like blurry spots on the sides of your vision that gradually lead to a tunneling effect before causing a total loss of vision. Symptoms such as these are usually tough to spot outside of an eye exam because the condition develops gradually.

Other symptoms specific to glaucoma that can come on suddenly include severe eye pain, headache, nausea or vomiting. If this happens, seek medical care immediately.

Risk factors other than age that can predispose you to glaucoma include having an African American or Hispanic background, suffering a previous eye injury, increased corneal thickness, diabetes, certain heart conditions and a family history of glaucoma.

Apart from vision loss, glaucoma can have a direct impact on your overall health. Older adults who are diagnosed with glaucoma are at an increased risk for:

Falling: The ability to judge depth and space is affected. For those who are 65 and older, this can cause serious injuries, such as to the head or hip, which can lead to a loss of independence.
Loss of daily living skills: The inability to complete daily activities, such as preparing food or getting dressed.
Depression: The fading or loss of vision can lead to the feeling of losing one’s independence.
Driving incidents: The halo effect of the headlights can make it harder to drive at night.
Headaches: Straining the eyes can create tension headaches.

There are plenty of treatment options available and it is important to know exactly what condition you are dealing with so that you can prevent symptoms from progressing and becoming irreversible. If you are 65 or older and diagnosed with glaucoma, regular, comprehensive dilated eye exams will help your eye care professional monitor your eye health and determine what level of pressure is normal for you.

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Some of the treatments that are available to those with glaucoma are medication, such as prescription eye drops that help lower eye pressure, or laser and conventional surgery. Laser surgery helps open the clog that is causing the build up and increases the outflow of fluid. With conventional surgery, a new way for fluid to leave the eye is created.

If glaucoma is diagnosed and treated in time, the ability to prevent additional vision loss is higher and may even prevent blindness. People who are 65 and older should schedule an eye exam every one to two years.

Taking care of yourself is top priority for living a long and healthy life. If you suspect that you are at risk for glaucoma, consult with your doctor today and check whether you need to see an eye specialist for a more comprehensive eye exam.

Dr. Jeffrey S. Luther is a native Southern Californian who came to MemorialCare in 1993 and was attracted to family medicine for its breadth and the opportunity to have lasting relationships with his patients across the age spectrum. As a faculty member of the Family Medicine Residency Program at MemorialCare Long Beach Medical Center, he balances his time providing patient care with teaching the next generation of family physicians.

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