Glaucoma, a leading cause of blindness
It’s the new year and one of your resolutions should be to get your eyes checked, advises Dr. Daniel Laroche, Director of Glaucoma Services and President of Advanced Eyecare of New York. Despite the busyness of the new year, he says it’s still important to stay on top of regular doctor visits, including visits with your eye doctor.
What is Glaucoma? Glaucoma is a disease of the eye characterized by three components:
1. Damage and loss of the retinal ganglions cells and optic nerve described as cupping
2. Loss of visual field
3. Usually increased eye pressure (the mean normal eye pressure is 15mmHG)
People at risk for glaucoma include the elderly, Blacks, people with elevated eye pressure, primary relatives with glaucoma, persons with high myopia, high hyperopia, history of eye trauma and diabetes. Blindness from glaucoma is insidious. In most cases, there is no pain, and the loss of vision occurs slowly from peripheral to central. The central reading vision is not affected until the end, thus most people do not realize it until they have lost a substantial amount of their peripheral vision. In low or normal pressure glaucoma, the central vision may be affected first.
The elevated intraocular pressure damages the optic nerve both mechanically and creates decreased blood flow to the eye. The most identifiable cause of glaucoma is the enlarged lens or cataract in the eye. Early cataract surgery and trabecular bypass has become the best option to stop vision loss in patients with glaucoma. The current use of eyedrops and laser help to lower intraocular pressure but do not address the causative mechanism of the glaucoma being the enlarged lens. Incisional cataract surgery and glaucoma surgery is often needed to truly stabilize glaucoma.
All people should be screened regularly for glaucoma as part of a medical eye exam. Screening should consist of an eye examination consisting of gonioscopy (examination of the drainage angle), intraocular pressure measurement with Goldmann applanation tonometry and a dilated optic nerve examination. If there appears to be any damage to the optic nerve or abnormal pressure, then a visual field test should be performed, and optic nerve photos taken. Persons with thin corneas should be more aggressively monitored and treated for glaucoma as the disease tends to be worse in these patients.
If you have eye pressure or glaucoma and feel that you may be losing vision, Dr. Laroche recommends that you seek the care of a glaucoma specialist for a second opinion. DON’T GO BLIND FROM GLAUCOMA! People with conditions such as glaucoma and diabetic retinopathy that could lead to blindness if left unchecked need to stay particularly vigilant with their checkups. The pandemic shouldn’t keep you from visiting your doctor, but for patients over 60, Dr. Laroche advises it's better to stay home and do telehealth visits or video consultations until the pandemic flattens. He also encourages people to wear face masks on visits and maintain social distancing, even if they are in a health clinic, and if you’re high-risk, consider adding eye protection when in public spaces.
“Eyesight or human vision is one of the most important senses. As much as 80 percent of what we feel comes through our sense of sight. By protecting the eyes, people will reduce the chance of blindness and vision loss while also staying on top of any developing eye diseases, such as glaucoma and cataracts.
“A healthy brain function requires a healthy vision. The brain is our most essential organ, and it allows us to control other organs. Normal and healthy vision contributes to improved learning and comprehension for a better quality of life,” says Dr. Laroche.
About Dr. Daniel Laroche
Dr. Laroche is an exceptional glaucoma specialist in New York. He studied and received his bachelor's degree from New York University and a medical doctorate with honors in research from Weil Cornell University Medical College. He underwent a medical internship at Montefiore Hospital and finished his ophthalmology residency at Howard University Hospital in Washington D.C., where he was the chief resident in his third year. He later completed his glaucoma fellowship at New York Eye and Ear.
For more information about Dr. Laroche, visit: www.advancedeyecareny.
To learn what causes glaucoma, watch https://www.youtube.com/watch?
To watch a glaucoma procedure, visit https://www.youtube.com/watch?
